Long Term Care Specialist I

at State of Vermont in Rutland, Vermont, United States

Job Description

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. Work in a supportive work environment with a Monday-Friday schedule, eleven paid state holidays, in addition to a robust benefits package.
 
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 time frames.
• 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 time frames 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.
 
Mission:
The Department of Vermont Health Access (DVHA)'s mission is to improve Vermonters' health and well-being by providing access to high-quality, cost-effective health care. We have identified three priorities that support our mission: Advancing value-based payments, modernizing information technology infrastructure, and operational performance improvement. Our department commits to executing our responsibilities and priorities while adhering to three core values: Transparency, Integrity and Service.

Diversity, Equity, and Inclusion:
As part of our values of transparency, integrity, and service, we are committed to supporting diversity, equity, inclusion, and accessibility as part of our person-centered culture. We actively celebrate our colleagues' and future colleagues' different abilities, racial identity, sexual orientation, ethnicity, age, and gender. Everyone is welcome and supported here.

Our State:
Vermont is a "small but mighty" state. We are ranked as one of the top 10 states to raise a family in 2022. We are nationwide leaders for progressive social and educational policies.  We are in Northern New England, 1.5 hours from Montreal and 3.5 hours from Boston. We have beautiful Lake Champlain, the Green Mountains, and year-round outdoor activities.

Duties are performed largely in an office setting. Workload usually heavy with constant need for prompt and accurate decisions. May experience frequent interruptions and shifting of priorities. Incumbents must be able to function independently. Private means of transportation should be available for necessary travel to training, mentoring and/or meetings. Applicants may provide a variety of challenges including but not limited to highly emotional conditions: belligerency, inability to communicate, attempts at falsification and total discouragement. May communicate with private attorneys engaged by applicants to help client with Long Term Care application and eligibility process. May consult with DVHA and/or AAG attorneys regarding fair hearings, extraordinary eligibility issues, rules interpretation or to gain assistance in responding to questions from client’s assistors or outside attorneys.