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MEDICAL CARE PROGRAM ASSOCIATE I

FULL-TIME CONTRACTUAL

Recruitment #18-004394-0011

GRADE

10

LOCATION OF POSITION

MDH, Office of Systems, Operations, and Pharmacy, Baltimore, MD

Main Purpose of Job

A Medical Care Program Associate I is the intermediate level of work in a Medical Assistance Program in the Department of Health. The main purpose of this position is to provide liaison services to the various Maryland Department of Health (MDH) and the Department of Health Services (DHS) administrations, long term care, acute hospital, hospice and home health provider community with matters related to claims payments, recipient eligibility and/or Long Term Care (LTC) coverage. This position functions within a Call Center environment and will serve as a primary information resource for the provider community and it's fiscal representatives that make inquiries and register complaints regarding policy and procedures effecting payment of claims. This position is responsible for applying and interpreting Medical Assistance regulations and policies regarding fee for service hospital services covered by the Program, recipient eligibility and/or Long Term Care (LTC) coverage. This individual must resolve and process complex problem cases/claims related to recipient eligibility, claims errors and LTC coverage. In addition, individuals must be able to exercise a significant degree of independence of action and decision-making with the ability to communicate with managers, various MDH/DHS administrations/units, providers and vendors as well as other duties, responsibilities, and qualifications may be required and/or assigned as necessary.

MINIMUM QUALIFICATIONS

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

Experience:  One year of clerical experience applying policies in a medical care, health insurance or federal or State entitlement program.

NOTES:

1. Additional general clerical experience may be substituted on a year-for-year basis for the required education.

2. Thirty credit hours from an accredited college or university may be substituted for the required experience.

SELECTION PROCESS

Applicants who meet the minimum (and selective) qualifications will be included in further evaluation. 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. Clearly indicate your college degree and major on your application, if applicable. For education obtained outside the U.S., any job offer will be contingent on the candidate providing an evaluation for equivalency by a foreign credential evaluation service prior to starting employment (and may be requested prior to interview). 

Complete applications must be submitted by the closing date. Information submitted after this date will not be added. 

Incorrect application forms will not be accepted. Resumes will not be accepted in lieu of a completed application.

Candidates may remain on the certified eligible list for a period of at least one year. The resulting certified eligible list for this recruitment may be used for similar positions in this or other State agencies.

BENEFITS

Contractual employees who work for an agency covered under the State Employee and Retiree Health and Welfare Benefits Program, have a current employment contract and work 30 or more hours a week (or on average 130 hours per month) may be eligible for subsidized health benefits coverage for themselves and their dependents. As a contractual employee, you will be responsible for paying 25% of the premiums for your medical and prescription coverage, including any eligible dependents you have enrolled. The State of Maryland will subsidize the remaining 75% of the cost for these benefits. You can also elect to enroll in dental coverage, accidental death and dismemberment insurance, and life insurance, but will be responsible to pay the full premium for these benefits.

Leave may be granted to a contractual employee who has worked 120 days in a 12 month period. This leave accrues at a rate of one hour for every 30 hours worked, not to exceed 40 hours per calendar year.

FURTHER INSTRUCTIONS

Online applications are highly recommended. However, if you are unable to apply online, the paper application (and supplemental questionnaire) may be submitted to MDH, Recruitment and Selection Division, 201 W. Preston St., Room 114-B, Baltimore, MD 21201. Paper application materials must be received by 5 pm, close of business, on the closing date for the recruitment, no postmarks will be accepted.

If additional information is required, the preferred method is to upload.  If you are unable to upload, please fax the requested information to 410-333-5689. Only additional materials that are required will be accepted for this recruitment. All additional information must be received by the closing date and time.

For questions regarding this recruitment, please contact the MDH Recruitment and Selection Division at 410-767-1251.

If you are having difficulty with your user account or have general questions about the online application system, please contact the MD Department of Budget and Management, Recruitment and Examination Division at 410-767-4850 or Application.Help@maryland.gov

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.

People with disabilities and bilingual candidates are encouraged to apply.

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



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