Official SealDepartment of Budget and Management


#19-000928-0006
Supplemental Questionnaire

Last Name
First Name
1.

Describe your experience determining medical assistance eligibility and interpreting medical assistance eligibility regulations.

This experience must also be included on your application (please include name of employer, job title, dates of employment and hours worked per week). If you do not possess this type of experience, please indicate N/A.


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