MEDICAID PROGRAM MANAGER 4

AS625 $84,552 - $165,901
Creation Date: 08/29/2005
Change Date: 01/01/2025

FUNCTION OF WORK:
To serve as the Section Chief administering all functions of large and complex Medicaid program(s).

LEVEL OF WORK:
Administrator

SUPERVISION RECEIVED:
Administrative direction from a higher-level administrator/executive.

SUPERVISION EXERCISED:
Supervision over lower-level positions.

JOB DISTINCTIONS:
Differs from Medicaid Program Manager 3 by serving as the Section Chief administering all functions of large and complex Medicaid program(s) and supervision exercised.

Differs from Medicaid Deputy Director by the absence of responsibility for the day-to-day management of Medical Vendor Administration.

CORE COMPETENCIES:
IDENTIFIED BY STATE CIVIL SERVICE, CORE COMPETENCIES ARE THE KNOWLEDGE, SKILLS, ABILITIES AND BEHAVIORS BASED ON THE WORK TASKS OUTLINED IN THE EXAMPLES OF WORK. MORE INFORMATION ON THE SCS COMPETENCY MODEL CAN BE FOUND HERE.

Demonstrating Accountability	Displaying Expertise	Driving Results
Following Policies and Procedures	Making Accurate Judgments	Thinking Strategically

EXAMPLES OF WORK:
EXAMPLES BELOW ARE A BRIEF SAMPLE OF COMMON DUTIES ASSOCIATED WITH THIS JOB TITLE. NOT ALL POSSIBLE TASKS ARE INCLUDED.

Serves as an assistant to the Medicaid Deputy Director and may direct agency in the absence of the Medicaid Deputy Director.

Administers comprehensive statewide Medicaid programs by formulating and implementing current and long-range plans, policies, procedures and regulations.

Participates in Medicaid budget planning, preparation, and grant administration.

Conducts investigations and makes recommendations for the Medicaid Director's response to grievances by Field Operations staff.

Monitors statewide field operations to determine the efficiency and effectiveness of the delivery of Medicaid Eligibility services.

Develops, monitors, and administers various methodology reimbursement policies.

Represents the Department in programmatic matters at various federal, state and local hearings, meetings, and conferences.

Monitors policies and procedures to ensure that policies and system requirements comply with the law and federal regulations.

Works closely with state, regional, and parish administrative staff in developing management procedures and operational plans to assure that all agency programs are implemented at the field operations level as intended by federal and state laws and regulations.

Coordinates with state level administrative and support staff to improve program development, identify staff training needs and provide management and support services required and needed by department staff.

QUALIFICATION REQUIREMENTS:
MINIMUM QUALIFICATIONS:
Two years of the required experience for the following minimum qualifications must have been at the supervisory level or above:

Eight 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 five 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 five 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 four 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.