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QUALITY IMPROVEMENT ORGANIZATION PROGRAM & OVERSIGHT MANAGER

PROGRAM MANAGER II - FULL TIME CONTRACTUAL

Recruitment #22-005477-0019

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GRADE

20

LOCATION OF POSITION

MDH, Developmental Disabilities Administration, Baltimore, MD

Main Purpose of Job

This position serves as the sole Quality Improvement Organization (QIO) Program and Oversight Manager for the Developmental Disabilities Administration’s (DDA) QIO program. The purpose of the QIO is to improve the effectiveness, efficiency, economy, and quality of services delivered to Medicare beneficiaries. The QIO provides oversight of the DDA’s Case Management System known as Coordination of Community Services.  The Program Manager will report to the Developmental Disabilities Administration (DDA) Director of Administrative Services and will provide weekly updates to the Developmental Disabilities Administration’s Deputy Secretary and Director of Program Services.  This position is responsible for managing the implementation of the QIO program by the contracted vendor and ensuring that the QIO vendor is performing according to the contract scope and providing utilization reviews and quarterly audits to ensure that the State pays only for services that are reasonable and necessary based on what has been approved in a participants Person-Centered Plan (PCP) and supported by sufficient documentation and case note activities.  This position also works in concert with the Case Management Manager in ensuring timely submission of Person-Centered Plans (PCPs). This position also works closely with other team members to address and rectify audit findings related to services rendered by the CCS agencies.

Coordination of Community Services are provided for various home and community-based services. The DDA operated Medicaid waiver programs include Family Supports, Community Supports, and Community Pathways.  These three programs are designed to provide integrated support services to participants and their families, which enable participants to work toward self-determination, independence, productivity, integration and inclusion in all facets of the community across their lifespans. The DDA programs are designed to provide Medicaid eligible individuals with community supports and services to help enable people with intellectual and developmental disabilities to receive services in their communities.

This position is responsible for the oversight and management of the Coordination of Community Services (CCS) compliance funded through the federal Targeted Case Management model, and collaborating with the QIO vendor to examine and analyze the business records and accounting systems of State agencies, grantees, businesses or other entities as appropriate to verify reliability, accuracy and compliance with generally accepted accounting principles and with statutes or contract provisions to ensure compliance with COMAR 10.09.48.01-.08 and COMAR 10.22 .02.02; 10.22.02.00, 10.22.02.14 regulations and State Plan.

The purpose of this position is to oversee all aspects of the QIO and CCS programs and act as a representative of DDA in discussions with the QIO vendor, coordination providers, individuals, families, and other stakeholders.

MINIMUM QUALIFICATIONS

Qualified applications must possess a bachelor's degree from an accredited college or university and 6 years of professional experience in health services, including at least three years of professional work experience related to treatment and development of developmentally disabled clients and three years must have been at the managerial or supervisory level.

SELECTION PROCESS

This is a Management Service position and serves at the pleasure of the Appointing Authority.  A resume must accompany your application.

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. 

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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