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MEDICAL CARE PROGRAM SUPERVISOR

MANAGER, PROVIDER RELATIONS DIVISION

Recruitment #25-000931-0003

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Introduction

** THIS RECRUITMENT IS LIMITED TO CURRENT MARYLAND DEPARTMENT OF HEALTH PROMOTIONAL CANDIDATES ONLY. **

GRADE

17

LOCATION OF POSITION

MDH - Medicaid Provider Services Administration
201 W. Preston Street
Baltimore, MD 21201

Main Purpose of Job

The main purpose of this position is to provide direct supervision to Medical Care Program Associates within the division that act as a liaison for internal and external entities, both public and private, regarding the Medicaid Program. This program provides services to the provider community and other Maryland Department of Health (MDH) administrations with matters related to claims payment errors. This position is the primary information resource for internal staff, the provider community, and its fiscal representatives that make inquiries and register complaints regarding policy and procedures affecting the payment of claims.

This position directs and provides consultation and assistance to public and private providers of service to the Medical Assistance Program. This position develops, recommends, and implements Medical Care Program policies and regulations, prepares reports, identifies discrepancies with systems related to policies, procedures, and payment records for Medicaid services and makes recommendations for corrective actions. Additionally, this position interprets and applies Medicaid Program policies and regulations; consults with MDH staff, service providers and representatives regarding benefits and claims issues for Medical Care Programs; develops, advises and participates in training programs related to the Medicaid Program; identifies methods for cost avoidance; participates in system development projects, audits, investigations and utilization review of the Medicaid Program for quality assurance; makes recommendations on unusual situations regarding policy interpretation; ensures that providers receive prompt and positive customer service by assuring that accurate information is disseminated and applied internally and externally with the interpretation of Medicaid regulations and policies regarding fee for service payments and or other related complex issues. 

Also, this position must train, direct and instruct lower-level staff and service providers in applying and interpreting Medical Assistance regulations and policies. This position must be able to exercise a significant degree of independence of action and decision-making with the ability to assist management with advising or creating standard operating procedures while communicating positively and professionally with managers, various MDH administrations, providers, and vendors. This position may operate in a hybrid manner, meaning job duties will be performed both remotely and on-site (e.g., 80% remote, 20% onsite), based on the designated telework schedule/plan that best fits the unit and or otherwise directed by the Appointing Authority. Other duties, responsibilities, and qualifications may be required and/or assigned as necessary.

MINIMUM QUALIFICATIONS

Experience: Eight years of administrative or professional experience developing or applying policies and regulations in medical assistance, health insurance, federal or State entitlement programs. One year of this experience must have been in a medical assistance program.

Notes:

1. Candidates may substitute the possession of a Bachelor's degree from an accredited college or university and four years of administrative or professional experience developing or applying policies and regulations in medical assistance, health insurance, federal or State entitlement programs for the required experience.  One year of this experience must have been in a medical assistance program.

2. Candidates may substitute the possession of a Master’s degree from an accredited college or university in the related field of work for the required experience.

3. Candidates may substitute U.S. Armed Forces military service experience as a commissioned officer in Operational Analysis classifications or Health Services Management specialty codes in the health-related field of work on a year-for-year basis for the required experience.

DESIRED OR PREFERRED QUALIFICATIONS

The desired candidate should possess the following:
  • Experience with oversight of the Provider Relations Call Center. 
  • Experience working in the Medicaid Check Tracing Unit.
  • Experience developing call center reporting metrics.

LIMITATIONS ON SELECTION

** THIS RECRUITMENT IS LIMITED TO CURRENT MARYLAND DEPARTMENT OF HEALTH PROMOTIONAL CANDIDATES ONLY. **

LICENSES, REGISTRATIONS AND CERTIFICATIONS

Employees in this classification 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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