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Recruitment #23-004394-0002




MDH, Maryland Medicaid Administration, Baltimore, MD

Main Purpose of Job

The Medical Care Program Associate in the Maryland Medicaid Administration performs both administrative and skilled functions to determine programmatic eligibility for medical assistance. By interpreting and applying the State and Federal policies, regulations, and procedures, these roles are responsible for the processing of claims and pre-authorizations, eligibility applications, and operating in call centers across various Medicaid programs including Eligibility Services (OES), Long Term Services & Supports (OLTSS), Medicaid Finance (OOF), Medical Benefits Management (OMBM), Medicaid Provider Services (OMPS), and Pharmacy Services (OPS).

Examples of work include:
  • Eligibility Determination: Interviewing applicants and authorized representatives to provide guidance and technical assistance on Medicaid programs and application processes.
  • Reviewing documents/verifications required to determine eligibility including financial statements, asset documents, citizenship, etc.
  • Running clearances in multiple data systems to verify technical, medical, and financial eligibility.
  • Analyze recipient coverage groups and eligibility in order to address provider claims concerns
  • Call Center Representative: Answering real-time calls daily from participants and providers seeking assistance with navigating Medicaid and tracking the disposition of the calls using a customer relationship management (CRM) system based on unit policies and procedures.
  • Educating participants and providers about Maryland Medicaid program benefits and services and navigation of the system of care utilizing knowledge of federal and state regulations and policies.
  • Determining strategies to address participant and/or provider inquiries, including potential medical complaints, and executing procedures to achieve resolution.
  • Determining appropriate course of action to assist participants and providers with billing issues, and either redirects the caller to the appropriate resource; escalates the issue toother units; or serves as the liaison between the caller, provider, and/or Medicaid to aid with resolution.


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.


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.


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

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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