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#18-001755-0037
Supplemental Questionnaire

Last Name
First Name

 

**Please note that your answers on the supplemental questionnaire must correspond to the information provided on your application to receive credit. Applications that do not include a completed supplemental questionnaire will be considered incomplete and may be subject to disapproval.**

 


1

This position is limited to current Maryland State employees of the Worcester County Health Department only.

Are you a current State employee of the Worcester County Health Department?

Yes No
2

Do you have 60 credit hours from an accredited college or university?

Yes No
3

Please describe your experience with Microsoft Excel.  Please include
employer and dates of employment. If you do not have this experience, enter
N/A.

4

Describe your knowledge of and/or experience working with Meaningful Use/Merit Incentive-Based Programs.

Please include name of employer, job title, dates of employment, and hours worked per week, this information must also be reflected in your application.  If you do not possess experience in this area, put N/A in the box below.

5

Describe your experience with Medicare and Medicaid credentialing.

Please include name of employer, job title, dates of employment, and hours worked per week, this information must also be reflected in your application.  If you do not possess experience in this area, put N/A in the box below.

 


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