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MEDICAL CARE PROGRAM ASSOCIATE SUPERVISOR

Supervisor, Provider Relations Unit

Recruitment #21-004435-0002

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GRADE

14

LOCATION OF POSITION

MDH/Office of Health Services, Medicaid Provider Services Administration/Provider Relations Unit, Baltimore, Maryland

Main Purpose of Job

This position will provide direct supervision to Medical Care Program Associates who are liaisons for both public and private internal and external entities of the Medicaid Program. This position will assist with CMS-1500 non-payment claim-related issues. This position will also serve as the primary information resource for internal lower-level staff members, policy staff members, the provider community, and fiscal representatives who make inquiries and register complaints regarding policies and procedures which affect the payment of claims.

This position will develop, recommend and implement medical care program policies and regulations. This position will also prepare reports and identify discrepancies in recipient eligibility, billing, pricing, and payment records for Medicaid services by making recommendations for corrective actions. Additionally, this position will interpret and apply Medicaid program policies and regulations; consult with service providers and representatives regarding benefits and claims issues for medical care programs; develop and participate in training courses related to the Medicaid Program; and, identify methods for cost avoidance. 

Furthermore, this position will participate in audits, investigations and utilization reviews of the Medicaid Program for quality assurance. In addition, this position will make recommendations on unusual situations regarding policy interpretation, as well as ensure that providers receive prompt and positive customer service by assuring that accurate information is disseminated and applied- both internally and externally- with the interpretation of Medicaid regulations and policies regarding fee-for-service institutional services. This position will be responsible for training, directing and instructing lower-level staff members and providers with the application and interpretation of medical assistance regulations and policies, in relation to claims. 

Finally, this position must be able to exercise a significant degree of high-level knowledge of Medicaid CMS-1500 billing, along with the independence of action and decision-making, with the ability to assist management with advising or creating standard operating procedures. This position must also be able to communicate positively and professionally with managers, various MDH administrators, providers, and vendors. This position will be expected to perform other duties and/or responsibilities, as necessary.

MINIMUM QUALIFICATIONS

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

Experience: Four years of clerical experience applying policies in a medical care, health insurance, or federal or State entitlement program, including two years of experience applying, interpreting and processing program specific information, policies, regulations, and guidelines in a medical care program.

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

2. College credits from an accredited college or university may be substituted for the required experience, at the rate of 30 credit hours for one year of experience.

DESIRED OR PREFERRED QUALIFICATIONS

The desired candidate should have supervisory experience, as well as experience with medical billing and call center operations.  

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 which 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, at 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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