MEDICAL CARE PROGRAM SPECIALIST II

15

MDH, Provider Enrollment Unit, Baltimore, MD

This position will develop and apply medical assistance policies and regulations for the Community Personal Assistance Services, Community First Choice, Increased Community Services, and Home and Community-based Options Waiver programs. This position will also interpret and apply policy and regulations for providers and other partners, acting as a liaison for the Department, communicating guidance, developing and conducting training, and offering consultation and technical assistance to providers of the aforementioned programs. This position will provide guidance to support staff and other personnel of the Department regarding the programs. This position will also review complaints against providers as documented on Reportable Events (RE) forms using information available in the Long Term Supports and Services (LTSS) Tracking System, Unit Claims Reports, program regulations, program policy statements as well as other pertinent section of the RE. This may require speaking with program participants, supports planner and the provider to gather additional information. Depending on the findings of the review, this position will follow-up with the provider about any consequences they may face (Plan of Correction, suspension, disenrollment, recovery of payments, etc.). This position will establish and edit provider screens, to create or modify program procedure codes and to review claims to assure that MMIS is making program payments that are consistent with program regulations. This position will also represent the Department in meetings and in telephone contacts with advocates, providers, and participants as directed by the Unit Supervisor or Division Chief.

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.

Notes: 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.

The desired candidate should have:

- data entry experience

- billing and compliance experience

- customer service experience

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 (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.

STATE OF MARYLAND BENEFITS

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.