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#18-005484-0002
Supplemental Questionnaire

Last Name
First Name

 

**Please note that your answers on the supplemental questionnaire must correspond to the information provided on your application to receive credit. Applications that do not include a completed supplemental questionnaire will be considered incomplete and may be subject to disapproval.**

 


1.

Do you possess a master's degree from an accredited college or university in a behavioral health or human services field, business administration, health care management, public administration, or related field of study?

Yes No
2.

In which field of study is your degree? If you do not have a degree, enter N/A.

3.

Do you possess a doctoral degree? If yes, please indicate the field of study in which you earned your degree.

4.

Describe your experience managing clinical and administration/operations in an organization which provides behavioral health services to children and adolescents.

With your description, please include name of employer, job title, dates of employment and hours worked per week for each relevant position.  This information must also be reflected on your resume or application.

5.

Describe your experience that included program management and direct supervision of staff.

With your description, please include name of employer, job title, dates of employment and hours worked per week for each relevant position.  This information must also be reflected on your resume or application.

6.

Describe your knowledge of Maryland's public behavioral health systems of care to children and adolescents including inpatient psychiatric services and Medicaid.

7.

Describe your experience with data driven decision making, clinical research methodology, and financial management including value based contracting.

With your description, please include name of employer, job title, dates of employment and hours worked per week for each relevant position.  This information must also be reflected on your resume or application.


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