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MEDICAL CARE PROGRAM MANAGER III

DIVISION CHIEF

Recruitment #25-000934-0002

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Introduction

GRADE

20

LOCATION OF POSITION

MDH - Office of Long Term Services & Supports
201 W. Preston Street
Baltimore, MD 21201

Main Purpose of Job

This position functions as the Chief, Division of Community Long Term Care (DCLTC), Office of Long Term Services and Supports. In this capacity, this position administers the activities of the DCLTC and provides personnel management of its employees. This includes planning, organizing, and supervising the work of the Division; developing, revising, and implementing protocols, guidelines and controls for the administration of new or existing Medicaid Assistance programs to include the Medical Day Care Services Waiver and the Waiver for Adults with Brain Injury; overseeing the operations of Waiver programs administered internally and by an operating state agency; monitoring changes in federal and State laws and regulations; making recommendations for Medical Assistance program response to changes in federal and State laws and regulations; managing the compliance of changes. This position represents the State, Maryland Department of Health, and Medical Assistance Program in dealing with officials from other agencies, states, the federal government, the health care industry, and in legal proceedings. Finally, this position acts, upon occasion, as the Assistant Director of the Office of Long Term Services and Supports (OLTSS) in the absence of that individual.

The Division’s approach is multi-disciplinary in that the activities which are performed to achieve its goals are performed by medical and administrative personnel. The Division will have seven (7) full-time personnel. Three (3) of these positions are occupied by medical care program specialist II being reclassified to health policy analysts, two (2) current health policy analyst I, one (1) Nurse Consultant, one (1) vacant health policy analyst II, and one (1) program supervisor. 

The Division is responsible for surveillance and utilization control, regulatory enforcement, preauthorization of enrollment to the Medical Day Care Services Waiver, access to services, and the development and drafting of regulatory changes and policies. The Division is also responsible for the development and renewal of Medical Assistance program authority renewals and amendments. The primary function of the DCLTC is to ensure the provision, professional quality, appropriateness, and medical necessity of health care services provided to and reimbursed on behalf of Medical Assistance beneficiaries. This position is responsible for overseeing the development and maintenance of procedures to meet these responsibilities and missions. This position serves as the contract monitor for the case management competitive solicitation, which includes oversight of the case management agencies by conducting at minimum, annual audits, monthly meetings, and quarterly training. 

This position will be responsible for direct supervision of the contract manager for the case management competitive solicitation for the Medical Day Care Services Waiver. Duties include monitoring and ensuring provider capacity, auditing, issuing provider solicitations, selecting providers, quality monitoring and compliance, training, provider relations, ensuring services are satisfactory and delivered on time; monitoring deliverables and progress; and identifying and addressing any issues related to case management service provision. 

The Division is responsible for two (2) separate and distinct programs within Medicaid. These programs are: 
 ● Medical Day Care Services Waiver (COMAR 10.09.07 and 10.09.61); and 
 ● The Waiver for Adults with Brain Injury (COMAR 10.09.49). 

The Division Chief is responsible for setting the goals and priorities of the DCLTC as well as coordinating and managing the Division’s efforts in realizing these goals. As such, this position routinely directs the staff in their interpretation and application of Medical Assistance regulations as well as overseeing and directing the activities of the professional staff within the Division. This role will ensure the Office of Long Term Services and Supports programs are providing quality services, responsiveness to constituents, delegates, and senators concerns; procurement efforts and contract award and monitoring move forward timely to comply with federal requirement, budgeting for program viability, stakeholder engagement, utilization of services and financial accountability, and responsiveness to management and upper management in areas of the two (2) Medicaid Waivers under the purview of the DCLTC. 

This position operates in a hybrid manner, meaning job duties will be performed both remotely and on-site unless otherwise directed by the appointing authority.

MINIMUM QUALIFICATIONS

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

Experience: Four years of experience supervising employees in developing and applying policies and regulations or directing a program or project in a medical care program.

Notes:

1. Candidates may substitute additional administrative or professional experience developing or applying policies and regulations in medical care, health insurance, federal or State entitlement programs or in a health or human service program on a year-for-year basis for the required education.

2. Candidates may substitute U.S. Armed Forces military service experience at a rank of Corporal/Petty Officer or higher as a commissioned officer in Health Care Administration classifications or Health Services Management specialty codes in the health-related field of work on a year-for-year basis for the required experience and education.

DESIRED OR PREFERRED QUALIFICATIONS

The desired candidate should possess the following:
  • Experience with system modifications; contract monitoring and procurement; researching, evaluating, and analyzing policies and data regarding Medicaid waiver programs  
  • Experience performing qualitative and quantitative analyses on programmatic data; applying program policies by verifying program specific eligibility for providers  
  • Experience writing, developing, and presenting various materials; managing a large, fast paced workload; managing multiple competing projects and deadlines 
  • Experience with Google productivity tools (i.e.; Docs, Sheets, Slides, etc.); Microsoft Office Suites (i.e.; productivity tools, Word, PPT., Excel, etc.); SmartSheets  
  • Experience with cross sectional collaboration and leading teams of members with varying skill levels

LICENSES, REGISTRATIONS AND CERTIFICATIONS

Employees in these classifications 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.

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 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.

MDHMedCare




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