GRADE
22
LOCATION OF POSITION
MDH, Office of Long-Term Services and Supports, Baltimore, MD
Main Purpose of Job
This position serves as the Assistant Director for Waiver and Nursing Services directorate
within the Office of Long Term Services and Supports (OLTSS). The Assistant Director
plans and directs the functional operations and processes for the following divisions:
Division of Provider Enrollment, Claims, and Compliance; Division of Clinical Support;
Division of Participant Enrollment and Service Review; and the Division of Nursing
Services. Additionally, the incumbent is responsible for the Financial Management and
Counseling Services (FMCS) contract implementation, oversight, and monitoring. The
Assistant Director manages the case management hierarchy and oversees the coordination of
services for dually-enrolled Medicaid participants.
The Division of Provider Enrollment, Claims, and Compliance, Division of Clinical
Support, and the Division of Participant Enrollment and Service review are responsible for
the operations of the Community First Choice (CFC), Community Personal Assistance
Services (CPAS), Increased Community Services (ICS), and Home and Community-Based
Options Waiver (“Community Options”) programs. In addition to operating these programs,
this triad is responsible for maintaining the federal authorities associated with each program,
engaging with stakeholders, drafting and implementing regulatory and sub regulatory
guidance, and performing quantitative and qualitative analyses to inform decisions related to
program operations. Each division is responsible for certain functions as noted below.
The Division of Provider Enrollment, Claims, and Compliance is responsible for monitoring
provider compliance with the home and community-based services (HCBS) settings rule –
specifically, ensuring that individuals with disabilities receiving HCBS have the same
opportunities as individuals without disabilities and are fully integrated in their communities.
As such, division staff conduct onsite visits and desk reviews to ascertain provider
compliance, provide technical assistance, and initiate disenrollment for non-compliance
providers. Additionally, division staff process manual claim adjustments, assist providers
with billing concerns, and provide technical assistance to providers interested in becoming a
Medicaid-enrolled provider.
The Division of Clinical Support is comprised of clinical and non-clinical staff. The clinical
staff conduct utilization review on medically complex plans of service for applicants and
participants in the CFC, CPAS, ICS, and Community Options programs. Additionally, the
clinicians serve as expert witnesses in appeal hearings to defend the Department’s decisions.
Both non-clinical and clinical staff investigate reportable events and make referrals to other
agencies as appropriate. This division provides oversight of the nurse monitoring program,
completion of the interRAI assessment, and completion of the Pre-admission Screening and
Resident Review (PASRR) Level II performed by the Local Health Departments (LHD)
across the State.
The Division of Participant Enrollment and Service Review has three units – Plan of Service,
Registry, and Enrollment. This team conducts utilization review for plans of service for
applicants and participants in the CFC, CPAS, ICS, and Community Options programs. The
registry team manages the Community Options registry and completes the monthly wave to
invite individuals from the registry to apply for the program. The enrollment team reviews
technical eligibility for the four aforementioned programs and processes the authorizations to
participate in the programs. This division is responsible for management and oversight of the
Competitive Solicitation for Comprehensive Case Management.
The Division of Nursing Services (DONS) is responsible for four separate and distinct
programs within Medicaid. These programs are home health services; home care for disabled
children under a Model Waiver; medical day care for children; and early and periodic
screening, diagnosis, and treatment (EPSDT) nursing services for individuals younger than
21 years old. This division is a multi-disciplinary team with staff who serve in medical and
administrative roles.
This position directly supervises the four division chiefs for each of the aforementioned
divisions. The Assistant Director is responsible for ensuring each division carries out its
assigned responsibilities and tasks while adhering to mandatory timeframes. The Assistant
Director is responsible for personnel tasks such as performance monitoring and onboarding
and offboarding of staff.
The position actively participates in planning efforts regarding long term care reform and
works with the Centers for Medicare and Medicaid Services (CMS) regarding quality and
compliance activities for federal home and community-based services programs. The
position reports directly to the Deputy Director of OLTSS and may act for the Deputy
Director in the Deputy Director’s absence or as assigned by the Deputy Director.
Program services for which the Assistant Director is responsible represent over $613 million
in Medicaid expenditures annually, serving a large portion of the Medical Assistance
population.
This position operates in a hybrid telework manner, with days in the office and remote days each week, as directed by the appointing
authority.
MINIMUM QUALIFICATIONS
Qualified applicants must possess a bachelor's degree from an accredited college or university, 6 years of professional health or human services experience, 2 years or more of experience working with a Medicaid program and at least 3 years of supervisory or managerial experience.
Additional professional level health or human services experience can be substituted for the bachelor's degree at the rate of 30 credit hours for 1 year of experience for up to 4 years.
DESIRED OR PREFERRED QUALIFICATIONS
Preferred candidates should possess two or more years of experience interpreting and implementing State and federal regulations.
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. 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.
