State of Maryland

A Medical Care Program Associate Supervisor is the supervisory level of work in a Medical Assistance Program in the Maryland Department of Health (MDH). Employees in this classification apply, interpret and process program specific information, policies, regulations and guidelines in a variety of program related activities.  Employees in this classification supervise lower-level Medical Care Program Associates and may oversee the work of clerical support staff.

Employees in this classification receive general supervision from a Medical Care Program Supervisor or Medical Care Program Manager.

Positions in this classification are evaluated by using the classification job evaluation methodology.  The use of this method involves comparing the assigned duties and responsibilities of a position to the job criteria found in the Nature of Work and Examples of Work sections of the class specification.

The Medical Care Program Associate Supervisor is differentiated from the Medical Care Program Associate Lead in that the Medical Care Program Associate Supervisor has supervisory responsibility for lower-level Medical Care Program Associates while the Medical Care Program Associate Lead assigns, reviews and approves the work of and trains lower-level Medical Care Program Associates.

Plans, coordinates, supervises and evaluates the work of lower-level Medical Care Program Associates;

Develops improvements or modifications to operating procedures and internal controls;

Provides advice and guidance to lower-level Medical Care Program Associates on the resolution of complex problems in reviewing and verifying medical assistance data (claims forms, encounter data, enrollment forms, adjustment forms, insurance data, or other related documents) for accuracy, completeness and compliance with State and federal regulations by applying appropriate Medical Care Program regulations, policies and procedures;

Secures or obtains missing data by calling or writing involved parties and completing appropriate forms;

Reviews and determines client eligibility for Medical Assistance programs;

Contacts insurance companies, health care providers, recipients and other governmental agencies in order to verify information submitted to the Medical Care Program for payment or review;

Responds to inquiries and complaints and provides liaison services to health care providers, insurance companies, other governmental agencies and recipients;

Prepares required reports and maintains a client/provider tracking system;

Enters, codes and maintains data into automated information systems;

May oversee the work of clerical support staff;

Performs other related duties.

Knowledge of Medical Care Program policies, procedures and regulations relevant to health care delivery systems;

Knowledge of basic math to prepare reports;

Skill in reviewing Medical Assistance data to interpret, clarify or apply Medical Care Program regulations, policies, procedures or guidelines;

Ability to supervise lower-level Medical Care Program Associates;

Ability to screen and respond to visitors and telephone inquiries;

Ability to maintain routine and confidential files, logs and program data;

Ability to organize findings and testify in administrative hearings;

Ability to understand, access and operate various computer information systems;

Ability to develop, revise and implement office procedures;

Ability to communicate effectively with co-workers, supervisors and the general public.

Education:   Graduation from an accredited high school or possession of a high school equivalency certificate.

Experience: Four years of clerical experience applying policies in a medical care, health insurance or federal or State entitlement program to include two years applying, interpreting and processing program specific information, policies, regulations and guidelines in a medical care program.

Notes:

1. Candidates may substitute additional general clerical experience on a year-for-year basis for the required education.

2. Candidates may substitute thirty credit hours from an accredited college or university for one year of the required experience.

Class specifications are broad descriptions covering groups of positions used by various State departments and agencies. Position descriptions maintained by the using department or agency specifically address the job functions of each position.

This is a Skilled Service classification in the State Personnel Management System.  All positions in this classification are Skilled Service positions.  Some positions in Skilled Service classifications may be designated Special Appointment in accordance with the State Personnel and Pensions Article, Section 6-405, Annotated Code of Maryland.

This classification is not assigned to a bargaining unit, as indicated by the designation of S (Supervisor), M (Manager), T (Agency Head), U (Board or Commission Member), W (Student), X (Used by Agency or Excluded by Executive Order), or Z (Confidential).  As provided by State Personnel and Pensions Article, Section 3-102, special appointment, temporary, contractual, supervisory, managerial and confidential employees are excluded from collective bargaining.  Additionally, certain executive branch agencies are exempt from collective bargaining and all positions in those agencies are excluded from collective bargaining.

Employees in this classification are eligible to receive overtime compensation.  An employee who works more than the normal workweek is entitled to be compensated for that overtime, as provided by the State Personnel and Pensions Article, Section 8-305.