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Recruitment #21-002419-0014




MDH, Division of Participant Enrollment and Service Review, Baltimore, MD

Main Purpose of Job

This position will perform high priority Medicaid policy analyses and implement high priority projects related to Medicaid home and community-based services. This position will primarily be responsible for performing utilization review of service plans for the Community Personal Assistance Services, Community First Choice, Increased Community Services, and Home and Community-based Options Waiver programs to ensure that supports are adequate to meet health and safety requirements and that all services are medically necessary and follow all applicable state and federal regulations.

This position will review standardized assessments, medical documentation, environmental assessments, and home improvement quotes to render a decision on request for services to ensure the wellbeing of the participant in a community setting. 

This position will accurately interpret and apply policy and federal and State regulations when reviewing and authorizing service requests for the aforementioned programs. This position will serve as a liaison for the Department, communicating guidance, developing and presenting training materials, and offering consultation and technical assistance of the aforementioned programs as it relates to service utilization, program eligibility, and policy/regulation compliance to applicants/participants/representatives, Supports Planners, Local Health Department representatives and other internal and external customers as needed. 

This position will also research, evaluate and analyze policies and data regarding the programs in order to improve policies and processes related to utilization review. This position will be responsible for analyzing health care data to support policy, programs and service development for the programs and will assist with development of LTSS programs and establish policy and compliance procedures for existing and new programs that fall under the Directorate. This position will interpret and apply policy and regulations for participants, supports planners and other partners, act as a liaison for the department, communicating guidance and offering consultation and technical assistance to both participants and support planning providers. This position will also provide guidance to support staff and other personnel of the Department regarding the programs. This position will represent the Division and the Department in meetings and in telephone contacts with advocates, supports planners, and participants. 


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

Experience: Two years of experience evaluating, analyzing, researching and developing health care services, policies and programs.


1. A Master's degree in Health Sciences, Health Care Administration, Public Health, Public Policy or closely related field may be substituted for one year of the required experience.

2. A PhD in Health Sciences, Health Care Administration, Public Health, Public Policy or closely related field may be substituted for the required experience.


The preferred candidate should possess the following:

  • Two years of experience accurately interpreting and applying Medical Assistance policies and regulations;
  • Two years of experience in a health related field or reviewing medical documentation in a medical office or nursing facility setting OR two years of experience as a certified nursing assistant (CNA) or geriatric nursing assistant (GNA), physical therapist assistant (PTA), occupational therapy assistant (OTA) OR  two years of experience developing or reviewing accessibility home improvement quotes or environmental assessments to increase the independence for individuals with physical challenges; 
  • Knowledge of Home and Community Based Waivers, Developmental Disabilities Administration;
  • Experience utilizing case management systems and/or data management systems; and
  • Written and verbal communication skills, problem resolution skills and be detail oriented.


Employees in this classification may be assigned duties which require the operation of a motor vehicle. Employees assigned such duties will 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.


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.


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

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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