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MEDICAL CARE PROGRAM SPECIALIST II

Regulatory Compliance Investigator- Recipient Fraud

Recruitment #19-000928-0004

GRADE

15

LOCATION OF POSITION

MD Department of Health, Office of the Inspector General, Baltimore, MD

Main Purpose of Job

The primary purpose of the Regulatory Compliance Inspector within the Office of the Inspector General (OIG) is to lead, coordinate and investigate allegations and complaints of suspected fraud, waste and abuse potentially committed by Medicaid recipients. This position is a skilled professional position which functions at the full performance level under general supervision to second line management within the Office of the Inspector General (OIG). This position completes reviews, inspections and investigations of Medicaid recipients to determine the disposition of allegations of Medicaid recipient fraud, waste and abuse based on referrals and complaints received by the Department from various internal and external private and public sources: local health departments (LHD), local Departments of Social Services (LDSS), MDH administrations, to include local state agencies and law enforcement entities.

MINIMUM QUALIFICATIONS

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.

DESIRED OR PREFERRED QUALIFICATIONS

The preferred applicant should have experience determining Medical Assistance eligibility or interpreting Medical Assistance eligibility regulations.

LICENSES, REGISTRATIONS AND CERTIFICATIONS

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.

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

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.



Click on a link below to apply for this position:

Fill out the Supplemental Questionnaire and Application NOW using the Internet. Apply Online
View and print the Supplemental Questionnaire. This recruitment requires completion of a supplemental questionnaire. You may view and print the supplemental questionnaire here.
Apply via Paper Application. You may also download and complete the Paper Application here.