MEDICAL CARE PROGRAM SPECIALIST II

15

The Department of Health and Mental Hygiene

Office of Health Services

201 W. Preston Street

Baltimore, MD  21201

The Contractual Medical Care Program Specialist II will develop and apply medical assistance policies and regulations for the Medical Assistance Personal Care Program, Community First Choice, Increased Community Services and Home and Community-Based Options Waiver Programs. The incumbent will verify eligibility and enroll participants, verify credentials and enroll providers, provide support to enrolled providers, acting as a liaison with participants, providers, and support planners in issues related to policy and regulations for the programs. The employee will also perform audits of provider claims, investigate billing issues, and resolve problems related to enrollment. Specialists monitor utilization and compliance with program rules. The Medical Care Program Specialist will interpret and apply policy and regulations for participants, providers, and other partners, acting as a liaison for the Department, communication guidance, developing and conducting training, and offering consultation and technical assistance to both participants and providers of the aforementioned programs, provide guidance to support staff and other personnel of the Department regarding the programs. The specialist will provide support in coordinating the Community Options Advisory Council and will represent the Department in meetings and in telephone contacts with advocates, providers, and participants.

Education:    A Bachelor's degree from an accredited college or university.

Experience:  Three years of administrative or professional experience developing or applying policies and regulations in medical assistance, health insurance, federal or State entitlement programs.

NOTE:

1.   Additional administrative or professional experience applying policies and regulations in medical assistance, health insurance, federal or State entitlement programs or in a health or human service program may be substituted on a year-for-year basis for the required education.

2.   A Master's degree in the related field of work can be substituted for the required experience.

3.  Candidates may substitute U.S. Armed Forces military service experience as a commissioned officer in Operational Analyst classifications or Health Services Management specialty codes in the health related field of work on a year-for-year basis for the required experience and education.

Employees in this classification may be assigned duties which require the operation of a motor vehicle. Employees assigned such duties may be required to possess a motor vehicle operator's license valid in the State of Maryland.

Applicants who meet the minimum qualifications will be evaluated. The evaluation may be a rating of your application based on your education, training and experience as they relate to the requirements of the position. Therefore, it is essential that you provide complete and accurate information on your application. Please report all related education, experience, dates and hours of work. For education obtained outside the U.S., a copy of the equivalent American education as determined by a foreign credential evaluation service must accompany the application. All information concerning your qualifications must be submitted by the closing date. We will not consider information submitted after this date. For Recorded Job Information Call: 410-767-6018.

As of January 1, 2015, contractual employees may be eligible for benefits.

STATE OF MARYLAND BENEFITS

Online application process is STRONGLY preferred. If online process is not available, please send your paper application to: DHMH, Recruitment and Selection Division, 201 W. Preston St., Room 114-B, Baltimore, MD 21201. The paper application must be received by 5 pm, close of business, on the closing date for the recruitment, no postmarks will be accepted.

Incorrect application forms will not be accepted.

If you need to submit additional information, the preferred method is to upload. If unable to upload, please fax requested information only to 410-333-5689.

Appropriate accommodations for individuals with disabilities are available upon request by calling: (410) 767-1251 or MD TTY Relay Service 1-800-735-2258.

We thank our Veterans for their service to our country, and encourage them to apply.

As an equal opportunity employer Maryland is committed to recruiting, retaining and promoting employees who are reflective of the State’s diversity.