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DIVISION CHIEF, MANAGED CARE

Medical Care Program Manager III

Recruitment #19-000934-0001

GRADE

19

LOCATION OF POSITION

MDH Division of HealthChoice Quality Assurance, Managed Care Administration, Baltimore, MD 21201

Main Purpose of Job

This position manages the Division of HealthChoice Quality Assurance which is responsible for developing, implementing and evaluating Quality Assurance activities for Medicaid’s managed care program, HealthChoice. This position monitors three major quality contracts, the largest of which is the External Quality Review Organization (EQRO) contractor. The EQRO performs managed care organization (MCO) systems performance reviews (SPR), EPSDT review, encounter data validation, validates Value Based Purchasing (VBP) measures, develops the consumer report card and provides technical assistance and oversight of required performance improvement projects (PIP). This position is also the contract monitor for the HEDIS vendor responsible for evaluating quality of care of the MCOs using nationally recognized standardized set of performance measures - Healthcare Effectiveness Data and Information Set (HEDIS).This position is responsible for the CAHPS vendor responsible for administering and analyzing the Consumer Assessment of Healthcare Providers and Systems (CAHPS) and Primary Care Provider Satisfaction Surveys. This position also provides technical assistance to and collaborates with internal and external partners and stakeholders.

MINIMUM QUALIFICATIONS

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

Experience: Four (4) 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. 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 may be substituted 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 a Master's degree from an accredited college or university and possess clinical experience.

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

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. 

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.




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