Medical Certification Specialist 2

Supplemental Information
NEDHSA is a designated approved National Health Service Corps (NHSC) site. Clinicians who work at NHSC-approved sites are eligible to apply to the NHSC Loan Repayment Program to pay off student loans.

*
2-year Full-Time Clinical Practice: NHSC will pay up to $50,000* for an initial 2 years of full-time clinical practice to clinicians.

(Full-time clinical practice is defined as no less than 40 hours per week, for a minimum of 45 weeks per year).

NEDHSA has had many productive years since forming as a Local Governing Entity (LGE) in 2013. Here's a small snapshot of how NEDHSA has worked diligently to provide our citizens with greater access to services, excellent customer services and quality, competent care.

• Tobacco Cessation Program
• Behavioral & Primary Healthcare Integration Summit
• Awarded Proclamation by Louisiana House of Representatives
• Support of Healthy Living with U-ACT (Union Parish Alliance for Transformation)
• LA Spirit Crisis Counseling Assistance Program (Recovery Resources for Flood Disaster Victims)
• Faith-Based Mental Health Summits
• Participant in the Caldwell Parish Annual Health Awareness Day
• Collaboration with NE Louisiana Behavioral Health Advisory Counsel
• Promotion of Healthy Living in Madison-Tallulah at Operation Stand Down healthcare and services fair

NEDHSA plans to build additional, esteemed partnerships this year to deepen meaningful integrated behavioral and primary healthcare within the region. To help the citizens realize more positive outcomes and stability, NEDHSA will continue to employ a more cohesive, progressive approach among our systems and processes.

International degrees require submission of an equivalency evaluation with the application.

Applicants will be required to serve a probationary period of a minimum of 12 months, not to exceed 24 months.

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

This position may be filled by Probation, Promotion, Demotion, Lateral Transfer or Detail to Special Duty. Preference may be given to permanent classified employees of Northeast Delta Human Services Authority.

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.

*Resumes WILL NOT be accepted in lieu of completed education and experience sections on your application. Applications may be rejected if incomplete.*

For further information about this vacancy contact:

Ms. Janesia Raybon, MPA
Human Resources Specialist
Northeast Delta Human Services Authority
2513 Ferrand Street
Monroe, LA 71201
(318) 362-3270

Qualifications

MINIMUM QUALIFICATIONS:
A baccalaureate degree plus three years of professional level experience in hospital or nursing home administration, public health administration, social services, nursing, pharmacy, dietetics/nutrition, physical therapy, occupational therapy, medical technology, or surveying and/or assessing health or social service programs or facilities for compliance with state and federal regulations.

SUBSTITUTIONS:
A current valid Louisiana license in one of the qualifying fields will substitute for the required baccalaureate degree.

A master's degree in hospital administration, nursing home administration, public health administration, social work, nursing, pharmacy, dietetics, nutrition, physical therapy, occupational therapy, or medical technology will substitute for a maximum of one year of the required experience.

NOTE:
Any college hours or degree must be from an accredited college or university.

NOTE:
A current valid Louisiana license in an individual field may be required for some positions.

NECESSARY SPECIAL REQUIREMENT:
FOR HEALTH STANDARDS SECTION JOBS ONLY
Federal regulations may mandate additional requirements prior to appointment.

Job Concepts

FUNCTION OF WORK:
To conduct surveys and/or assessments to verify that the services provided to individuals by providers, facilities, waivers, and/or long term care programs are in compliance with federal certification, state regulations, and established state standards.

LEVEL OF WORK:
Advanced.

SUPERVISION RECEIVED:
Broad direction from Medical Certification Supervisor or other higher level agency administrator.

SUPERVISION EXERCISED:
None.

LOCATION OF WORK:
Department of Health and Hospitals.

JOB DISTINCTIONS:
Differs from Medical Certification Specialist 1 by the possession of the Centers for Medicare and Medicaid Services certification and by the level of independence exercised in carrying out work responsibilities.

Differs from Medical Certification Supervisor by the absence of supervisory responsibilities.

Examples of Work

EXAMPLES LISTED BELOW ARE BRIEF SAMPLES OF COMMON DUTIES ASSOCIATED WITH THIS JOB TITLE. PLEASE NOTE THAT NOT ALL TASKS ARE INCLUDED.

Conducts surveys of health and social services programs, facilities, and providers that are state licensed and/or certified for state and federal programs.

Conducts assessments to ensure receipt of quality services by contracted providers.

Studies the facility or other enrolled providers relative to quality of medical services to determine the extent of compliance with state/federal regulations, state licensing, or established state standards.

Obtains information from review of records, staff interviews, resident interviews, personal observations relative to the operation of the medical facility, compliance standards, and quality of medical care provided.

Evaluates equipment and environmental factors of a facility for compliance with federal and state regulations.

Compiles information derived from surveys or paid Medicaid claims data and reports findings to recommend whether licensure and/or certification should be granted, denied, deferred, continued, or a change in Medicaid reimbursement is warranted.

Evaluates the appropriateness and the quality of medical care based on personal observations, resident interviews, or established state performance standards.
Presents survey findings to staff and/or governing bodies of facilities.

Conducts special investigations in response to complaints and reports findings.

Certify individuals as medically eligible to receive waiver services.

Creates and monitors a continuous quality improvement process.

Approves waiver recipient comprehensive plan of care and annually evaluates the overall effectiveness of waiver recipient comprehensive plan of care. Ensures that personal outcomes resulting from the receipt of waiver services are reflective of the person-centered goals identified in their comprehensive plan of care.

Conducts quality assurance of case management agencies and service providers relative to organization, policies and procedures, administration, qualifications of staff and quality of services to determine the extent of compliance with Medicaid regulations and waiver recipients comprehensive plan of care.

Receives, reviews, and determines appropriateness of recipient appeals of denied services. Gathers factual information and prepares summary of evidence. Presents testimony before Administrative Law Judge.

Job Type: Full-time

Pay: $4,696.00 - $8,866.00 per month

Salary : $50,000 - $0