MEDICAL CARE PROGRAM ASSOCIATE I

ASTD10

MDH - Medical Benefits Management

This full-time contractual position functions as a telephone triage agent. Through various 800 toll-free helplines for the Office of Medical Benefits Management under the Division of HealthChoice Community Liaison and Care Coordination, the agent provides customer service and resolution for recipient/provider concerns for various Medicaid programs which include but are not limited to, HealthChoice, Maryland Children’s Health Program (MCHP) and the Family Planning program. Assessments are determined for inquiry versus complaint calls, which are then documented in the Customer Relations Management (CRM) System, per standard operating procedures (SOP). Education is provided to recipients and providers regarding Medicaid system access and navigation by reviewing State and Federal regulations, policies, and procedures. The agent is expected to triage all medical complaints from recipients/providers in the Medicaid Programs and is required to document the complaint/issue in the CRM database. All complex medical complaints are referred to the Division of HealthChoice Complaint Resolution, also known as the Complaint Resolution Unit or CRU.

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

Experience: One year of clerical experience applying policies in a medical care, health insurance or federal or State entitlement program.

Notes:

1. Candidates may substitute additional general clerical experience on a year-for-year basis for the required education.

2. Candidates may substitute thirty credit hours from an accredited college or university for the required experience.

The desired candidate should possess the following:

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.

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.