Program Manager 1-A

State of Louisiana - New Orleans, LA

Full-time | Commission
Supplemental Information

JOB NUMBER: OPH/AS/1113

This position is located within the Louisiana Department of Health l Office of Public Health l Administrative & Financial Services-Revenue l ORLEANS Parish.

Cost Center: 326-0600
Position #:50576912

The Office of Public Health (OPH) has a complex finance structure and operates over 50 extensive programs utilizing staff in 63 parish health units and 3 specialty clinics, nine regional offices, three centers, 15 bureaus, and manages approximately 600 contractual agreements. There are approximately 275 Expenditure Organizations utilizing multi-source funding. The agency provides a variety of personal health care services, environmental health services and vital records statistical services.

The OPH Revenue Unit is responsible for ensuring the billing and collection of fees generated through patient co-payments, environmental health fees, and Emergency Medical Services fees totaling approximately $45M annually.

This position is responsible for overseeing the processing of professional charges that are associated with the statewide provision of Tuberculosis, Immunization, and HIV/STD services within the 60 plus Parish Health Units in all nine (9) Regions of the State of Louisiana. This position is responsible for the evaluation and management of Tuberculosis, Immunization, and HIV/STD CPT, HCPCS, and diagnosis codes and work with the Revenue Administrator, Program Directors, Regional Medical Directors and Administrators, and OPH clinical staff statewide to ensure precision and accuracy of reimbursements and coding. Responsibilities also include developing and coordinating reports; maintaining electronic financial batches and super bills; identifying consistent errors in coding and providing ongoing training to approximately 300 OPH clinical staff providing services in PHUs or specialty clinics statewide to avert such errors in the future.

This vacancy is being announced as a Classified position and may be filled either as a Job Appointment, Probationary Appointment or Promotional Appointment.

Resumes will not be accepted in lieu of a completed application. You must include all relevant education and experience on your official State application. You must describe your actual duties as you will not be qualified based on job title alone.

A resume upload will NOT populate your information into your application.

Work experience left off your electronic application or only included in an attached resume is not eligible to receive credit

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 by selecting the 'Applications' link after logging into their account. Below are the most common status messages and their meanings.

Application received - Your application has been submitted successfully.

Evaluating experience - Your application is being reviewed to ensure you meet the minimum qualifications for the position.

Minimum Qualification Review – See History – Click the History link for the results of your application review. Passing candidates will designate as "Pass". Failing candidates will designate as "Fail".

Eligible for consideration - You are among a group of applicants who MAY be selected for the position.

Eligible Pending Supplemental Qualification Review - Only candidates meeting the supplemental qualification will be eligible for referral.

Referred to hiring manager for review - Your application has been delivered to the hiring manager. You may or may not be called for an interview.

Position filled - Someone has been selected for the position.

Position canceled - The agency has decided not to fill the position.

The State of Louisiana only accepts online applications. Paper applications will not be accepted. Computer access is available at your local library, at local Louisiana Workforce Commission Business Career Solutions Centers (Download PDF reader), and at the State Civil Service Testing and Recruiting Center at 5825 Florida Boulevard, Room 1070, Baton Rouge, LA 70806. If you require an ADA accommodation, please contact our office at (225) 925-1911 or Toll Free: (866) 783-5462 during business hours for additional assistance.

(Please note: Libraries and LWC centers cannot provide in-depth assistance to applicants with limited computer skills; therefore, we suggest that such applicants have someone with computer proficiency accompany them to these facilities to assist with the computer application process. Also, no State Civil Service employees are housed at the libraries or LWC centers to answer specific questions about the hiring process. Such questions should be directed to the State Civil Service Testing and Recruiting Center at the phone numbers above or by visiting the office on Florida Blvd. where assistance is available. Information is also provided on our job seeker website at https://jobs.civilservice.louisiana.gov/).

DISQUALIFICATION:
While we encourage all interested applicants to apply, please be aware that there are various reasons that your application may be disqualified from consideration including, but not limited, to:
Failure to fully complete the education and work experience sections of the application; (Please note for the education section that the semester area refers to the # of credit HOURS and not the # of semesters you completed)
Failure to list complete license information (if applicable to the job position).
Failure to submit an equivalency evaluation statement for an international degree by the closing of this announcement.

For further information about this vacancy contact:
Angela Selders: angela.selders@la.gov
or
LDH/HRTSD
PO Box 4818
Baton Rouge, LA 70821

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

MINIMUM QUALIFICATIONS:
A baccalaureate degree plus four years of professional level experience in administrative services, economics, public health, public relations, social services, health services, or surveying and/or assessing health or social service programs or facilities for compliance with state and federal regulations.

SUBSTITUTIONS:
Six years of full-time work experience in any field may be substituted for the required baccalaureate degree.

Candidates without a baccalaureate degree may combine work experience and college credit to substitute for the baccalaureate degree as follows:

A maximum of 120 semester hours may be combined with experience to substitute for the baccalaureate degree.

30 to 59 semester hours credit will substitute for one year of experience towards the baccalaureate degree.
60 to 89 semester hours credit will substitute for two years of experience towards the baccalaureate degree.
90 to 119 semester hours credit will substitute for three years of experience towards the baccalaureate degree.
120 or more semester hours credit will substitute for four years of experience towards the baccalaureate degree.

College credit earned without obtaining a baccalaureate degree may be substituted for a maximum of four years full-time work experience towards the baccalaureate degree. Candidates with 120 or more semester hours of credit, but without a degree, must also have at least two years of full-time work experience to substitute for the baccalaureate degree.

Graduate training with eighteen semester hours in one or any combination of the following fields will substitute for a maximum of one year of the required experience on the basis of thirty semester hours for one year of experience: public health; public relations; counseling; social work; psychology; rehabilitation services; economics; statistics; experimental/applied statistics; business, public, or health administration.

A Juris Doctorate will substitute for one year of the required experience.

A master's degree in public health; counseling; social work; psychology; rehabilitation services; economics; business, public, or health administration will substitute for one year of the required experience.

Graduate training with less than a Ph.D. will substitute for a maximum of one year of the required experience.

A Ph.D. in public health; counseling; social work; psychology; rehabilitation services; economics; business, public, or health administration will substitute for two years of the required experience.

NOTE:
Graduate training will substitute for a maximum of two years of the required experience.

NOTES:
Health services include all services dealing with the diagnosis and treatment of disease, or the promotion, maintenance and restoration of health for sick or injured individuals.

Examples of public health jobs include sanitarian, public health engineer and public health epidemiologist.

NOTE:
Any college hours or degree must be from a school accredited by one of the following regional accrediting bodies: the Middle States Commission on Higher Education; the New England Commission of Higher Education; the Higher Learning Commission; the Northwest Commission on Colleges and Universities; the Southern Association of Colleges and Schools; and the Western Association of Schools and Colleges.

Job Concepts

Function of Work:
To administer small and less complex statewide health or social service program(s).

Level of Work:
Program Manager.

Supervision Received:
Broad direction from a higher-level manager/administrator.

Supervision Exercised:
May provide functional supervision in accordance with the Civil Service Allocation Criteria Memo.

Location of Work:
Department of Health and Hospitals; Human Service Districts as established; and other social service entities as established by an approved DSCS Allocation Criteria Memorandum.

Job Distinctions:
Differs from Program Monitor-DHH and Program Monitor Supervisor-DHH by the presence of responsibility for administering small or less complex statewide program(s).

Differs from a Program Manager 1-B-DHH by the absence of supervisory responsibility.

Differs from a Program Manager 2-DHH by the absence of responsibility for administering medium or medium complex statewide program(s).

Examples of Work
60% Coding/Reimbursement/ Collections Functions
Maintain expertise in the current procedure and diagnosis master file. Ensure OPH clinical staff providing Tuberculosis, Immunization, and HIV/STD services in PHUs or specialty clinics statewide are following policies and procedures related to reimbursements and coding. Responsible for research and promulgation of patient co-payment rules and regulations. Maintain visibility on any Electronic Health Records (EHR) system updates and incorporate any revisions required of the Front Office Manual to reflect changes in the EHR.

Identify OPH clinical staff providing Tuberculosis, Immunization, and HIV/STD services in PHUs or specialty clinics statewide who continue to have claims that are denied due to coding errors. Provide data for the production of monthly reports to OPH Executive Staff, Revenue Administrator, Program Directors, Regional Medical Directors and Administrators. Provide information needed to address issues with staff and provide continuous training to identified staff to improve coding accuracy.

Maintain fee schedules for Medicaid, Healthy Louisiana Plans, private payors, fee for service, co-pays and health maintenance organizations. Review reimbursements from third party payors to ensure payments are accurate and notify the Contracting Credentialing Manager of any discrepancies. Maintain electronic super bill standard fee schedule.

Verify that daily close out procedures are followed correctly by OPH clinical staff and ensure that batches are posted timely and accurately. Assist clinics with month end close of batches which includes deposit reconciliations. Perform daily review of the OPH Revenue email account to ensure that PHUs have submitted daily reports, which include reconciliation reports, deposits lists, and deposit slips. Ensure that the daily reports received are properly saved in the Revenue Deposits shared file. Ensure that the Monthly Deposit Reconciliation report is submitted to the Fiscal Office for review.

Work with Revenue Contractor, PHU and specialty clinic staff to resolve Tuberculosis, Immunization, and HIV/STD denials for the Regions they are assigned.

Support Statewide Revenue Manager and Revenue Contractor as needed with collection reporting and maintaining a current collections accounts receivable.

Provide specialized, technical assistance and training to all OPH clinical staff statewide regarding coding; reimbursements; monitoring of cash, check and credit card collections; collecting payments; attaching insurance provider information to the encounters; verifying patient's eligibility; submitting the super bills; reviewing the patient check-in and check-out processes; and properly operating the EHR.

Manage Medicaid, Health Louisiana and private payor reimbursements and maintain related files. Ensure information is available for peer and Medicaid review.

30% Tuberculosis, Immunization and STD/HIV Training and Outreach Management
Routinely provide training to clinical staff in the PHUs and specialty clinics to ensure they are utilizing correct codes for services such as Laboratory Tests; Preventive Health Screenings; STD/HIV Testing and STD Treatment; Counseling; Health Education; Community Outreach; Referral Services; and Immunizations.

Examining and evaluating staff competency needs and developing revenue reimbursement, collections and coding training policies, procedures and manuals relating thereto. Implementing and modifying trainings provided to the entirety of agency on new and existing policies/procedures, etc.

In the process of examining and evaluating training needs, collaborate with Revenue Unit leadership to ensure cash management policies developed in conjunction with LDH Payment Management appropriately capture agency needs and reflect agency policies and procedures.

10% Other Duties
Perform miscellaneous job duties as assigned. Work as needed during emergency operations as directed. Maintain current training required by LDH, FEMA, and any other entity.