Long Term Care Specialist I
Make a difference for Vermonters by maintaining an active Medicaid caseload & processing new applications at the Department of Vermont Health Access (DVHA). The Long Term Care (LTC) unit is seeking Long Term Care Specialist I position. Receive in depth training on a broad range of Medicaid programs for: Aged, Blind and/or Disabled, Long Term Care, and Choices for Care. Have the work/life balance you need with a Monday-Friday schedule and a supportive hybrid work environment. Eleven paid state holidays, in addition to a robust benefits package.
*Starting rate may be negotiable based on experience and qualifications.
The Long Term Care Specialist position has the following responsibilities:
· Maintains effective control of an active Medicaid caseload and processes new applications.
· 60 month Look Back Period to determine if there are applicable penalty periods.
· Making complex Medicaid eligibility determinations consistent with rules and policy and within prescribed timeframes.
· Conduct independent research and analysis prior to meeting with their mentor or supervisor about a case.
· Must Take refresher training as appropriate.
· Re-determines program eligibility at prescribed timeframes or when changes in client circumstances dictate review.
· Must complete work in a timely and efficient manner as there are federal timelines standards that the department is held to. Failure to adhere to those standards may result in financial penalties for the department.
· May prepare reports, fair hearing requests, and fraud referrals.
· May testify at Fair Hearings. Performs related duties and other assigned duties as required.
· Read and understand detailed instructions in order to accurately perform tasks accordingly.
Work is performed with considerable oversight of LTC Mentors and Supervisors. Workload levels are assigned commensurate with level of experience. The ideal candidate will have strong interpersonal, organizational, and IT skills.
Associates degree AND two (2) years or more of experience in a field related to health care administration, insurance, banking, accounting, para-legal services, auditing or federal grants management. Other related work environments may be considered if they require: reading, comprehension and application of complex rules, regulations, policies and procedures to perform the work.
High School diploma or equivalent AND four (4) years or more of experience in a field related to health care administration, insurance, banking, accounting, para-legal services, auditingor federal grants management. Other related work environments may be considered if they require: reading, comprehension and application of complex rules, regulations, policies and procedures to perform the work.