Medicaid Program Integrity Jobs in Louisiana (NOW HIRING)

MEDICAID PROGRAM MONITOR

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MEDICAID PROGRAM MONITOR

Salary

$4,387.00 - $8,608.00 Monthly

Location

Baton Rouge, LA

Job Type

Classified

Job Number

MVA/PJ/224998

Department

LDH-Medical Vendor Administration

Opening Date

08/19/2026

Closing Date

8/29/2026 11:59 PM Central

• Description

• Benefits

• Questions

About this Job

The mission of the Louisiana Department of Health is to protect and promote health and to ensure access to medical, preventive, and rehabilitative services for all residents of the State of Louisiana.

Learn more about Louisiana Department of Health (https://ldh.la.gov/)

Make a Difference in Louisiana Medicaid!Join the Louisiana Department of Health’s Medicaid team and play a critical role in protecting program integrity and ensuring eligible individuals receive the benefits they need. In this position, you’ll use your Medicaid expertise to analyze complex federal and state data, investigate eligibility information, and collaborate with staff, policy teams, and legal partners to make informed case decisions. If you’re ready to apply your skills to work that directly impacts the health and well-being of Louisiana residents,we encourage you to apply!

Minimum Qualifications

Six years of experience in developing, managing, or evaluating health or social service programs; or in public health, public relations, social services, health services, health regulation, or administrative services; OR

Six years of full-time work experience in any field plus three years of experience in developing, managing, or evaluating health or social service programs; or in public health, public relations, social services, health services, health regulation, or administrative services; OR

A bachelor’s degree plus three years of experience in developing, managing, or evaluating health or social service programs; or in public health, public relations, social services, health services, health regulation, or administrative services; OR

An advanced degree or a Juris Doctorate plus two years of experience in developing, managing, or evaluating health or social service programs; or in public health, public relations, social services, health services, health regulation, or administrative services.

EXPERIENCE SUBSTITUTION:

Every 30 semester hours earned from an accredited college or university will be credited as one year of experience towards the six years of full-time work experience in any field. The maximum substitution allowed is 120 semester hours which substitutes for a maximum of four years of experience in any field.

Job Specification

The official job specifications for this role, as defined by the State Civil Service, can be foundhere (https://apps01.civilservice.louisiana.gov/onestopjobinfo/DisplayJobSpec.aspx?JobCode=169240) .

Job Duties and Other Information

Job Duties:

· Conducts post-eligibility reviews of Medicaid/LaCHIP eligibility determinations, evaluating financial and non-financial factors for compliance with applicable state and federal requirements.

· Reviews income and other eligibility data from federal and state systems, including Federal Data Services Hub and IRS information, to verify eligibility determinations.

· Documents case findings, corrective actions, policy references, and case activity in appropriate systems and files, and issues required written notifications to applicants and enrollees.

· Updates and maintains eligibility information in the Louisiana Medicaid Eligibility Determination System (LaMEDS), determines current eligibility, and authorizes final eligibility decisions.

· Supports the Centralized Appeal Unit by assisting with fair hearing requests, representing the agency during hearings when needed, and taking appropriate action based on hearing and Administrative Law decisions.

· Interprets and applies complex federal, state, and agency policies and provides assistance with quality control reviews, payment error responses, provider or member inquiries, and eligibility-related complaints.

· Analyzes and reports review findings and trends, notifies management of recurring errors or concerns, and refers appropriate cases to the Medicaid Fraud Unit.

Position-Specific Details:

Location: Medical Vendor Administration / Eligibility Program Operations / East Baton Rouge Parish

Appointment Type: Probational appointment or Promotional appointment of a current permanent employee with Louisiana Department of Health

Cost Center: 305-2050401

Position Number(s): 50493626

How To Apply:

No Civil Service test score is required in order to be considered for this vacancy.

To apply for this vacancy, click on the “Apply” link above and complete an electronic application, which can be used for this vacancy as well as future job opportunities. Applicants are responsible for checking the status of their application to determine where they are in the recruitment process.

Further status message information is located under the Information section of the Current Job Opportunities page.

*Information to support your eligibility for the position must be included in the application (i.e., relevant, detailed experience/education). Resumes will not be accepted in lieu of completed education and experience sections. Applications may be rejected if incomplete.

Contact Information:

Paula Jackson-paula.jackson@la.gov

LA Department of Health (LDH)

Division of Human Resources

PO Box 4818

Baton Rouge, LA 70821

225-342-6477

This organization participates in E-verify, and for more information on E-verify, please contact DHS at 1-888-464-4218.

LDH supports Louisiana’s commitment to being a State as a Model Employer (SAME) by promoting the recruitment, hiring, and retention of individuals with disabilities.Information on the Louisiana Works, Louisiana Rehabilitation Services is available here (https://www.laworks.net/workforcedev/lrs/lrs_rehabilitation.asp) .

LDH is an equal opportunity employer and seeks to recruit a highly productive and diverse workforce and will provide equal employment opportunities to all employees and prospective employees. Employment decisions shall be based strictly on merit and without regard to religious or political beliefs, sex, race, or any other non-merit factor.

Louisiana State Government represents a wide variety of career options and offers an outstanding opportunity tomake a differencethrough public service. With an array of career opportunities in every major metropolitan center and in many rural areas, state employment provides an outstanding option to begin or continue your career.

As a state employee, you will earn competitive pay, choose from a variety of benefits, and have access to a great professional development program:

Insurance Coverage More information can be found at https://info.groupbenefits.org/

Parental Leave– Up to six weeks paid parental leave

More information can be found athttps://www.civilservice.louisiana.gov/Parental-Leave/Default.aspx

Holidays and Leave – State employees receive the following paid holidays each year:

• New Year's Day

• Martin Luther King, Jr. Day,

• Mardi Gras,

• Good Friday,

• Memorial Day,

• Independence Day,

• Labor Day,

• Veteran's Day,

• Thanksgiving Day and Christmas Day.

***** Additional holidays may be proclaimed by the Governor

State employees earn sick and annual leave which can be accumulated and saved for future use. Your accrual rate increases as your years of service increase.

Retirement – State of Louisiana employees are eligible to participate in various retirement systems (based on the type of appointment and agency for which an employee works). These retirement systems provide retirement allowances and other benefits for state officers and employees and their beneficiaries. State retirement systems may include (but are not limited to):

• Louisiana State Employees Retirement System (www.lasersonline.org). LASERS has provided this video (https://lasersonline.org/wp-content/uploads/2016/07/Your_Retirement_System.mp4) to give you more detailed information about their system

• Teacher's Retirement System of Louisiana (www.trsl.org),

• Louisiana School Employees Retirement System (www.lsers.net), among others

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To ensure compliance with LDH Nepotism Policy#41, if you have any immediate family members that are currently employed by LDH, please list the name and relationship. Please type “N/A” if no immediate family members are employed by LDH.

Required Question

Employer

State of Louisiana

Address

1201 N 3rd St

Baton Rouge, Louisiana, 70802

Phone

(866) 783-5462

Website

http://agency.governmentjobs.com/louisiana/default.cfm

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