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MEDICAL CARE PROGRAM ASSOCIATE LEAD/ADVANCED

ELIGIBILITY DETERMINATION ASSOCIATE LEAD WORKER

Recruitment #24-004434-0001

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Introduction

GRADE

ASTD12

LOCATION OF POSITION

MDH - Eligibility Determination Division
6 St. Paul Street
Baltimore, MD 21202

Main Purpose of Job

The primary function of the Eligibility Determination Associate Lead Worker (Medical Care Program Associate Lead/Advanced) is to assign, analyze, issue corrective action requests, and approve the work of an Eligibility Determination Associate I and/or II (Medical Care Program Associate I/II) for Non-MAGI and/or MAGI Medicaid based on accurate analysis and interpretation of regulations and policies. Eligibility Determination Associate Lead Workers may also assist with training Eligibility Determination Associates I and/or II and drafting Standard Operating Protocols. The Lead Worker may also participate in the appeals process and hearings. 

The Eligibility Determination Associate Lead Worker must continuously be knowledgeable of federal and State Medicaid regulations and policies. This knowledge is imperative to the Lead Worker’s success in analyzing eligibility determinations to ensure regulations and policies were interpreted and applied accurately and timely by Eligibility Determination Associates I and/or II. The Lead Worker’s review must ensure the Eligibility Determination Associates I and/or II accurately reviewed and authenticated verifications including but not limited to applications, technical verifications, income, asset, resource, financial verifications, and clearances in the appropriate federal and state data systems for accuracy and timeliness compliance when rendering their eligibility decision. This knowledge is also required when assisting Supervisors with training Eligibility Determination Associates I and/or II, drafting Standard Operating Protocols (SOP) and serving as the Department’s expert witness at administrative appeals hearings. The Lead Worker may participate in the appeals process by conducting pre-hearing conferences, providing expert testimony based on accurate analysis of federal and State regulations and policies at administrative appeals hearings and ensuring compliance to the Administrative Law Judge’s dispositions. 

The Lead Worker may assist the Supervisor with maintaining data reports for key performance indicators related to assigned and/or reviewed work. Additionally, the Lead Worker may have contact with applicants, recipients, authorized representatives or federal and State government entities to address complex cases or cases as a result of the Department of State's inquiry process. 

At all times, this position will provide customer service to both internal and external customers that meet or exceed the standards by EDD, the Department, and or State.

MINIMUM QUALIFICATIONS

Education:   Graduation from an accredited high school or possession of a high school equivalency certificate.

Experience: Three years of clerical experience applying policies in a medical care, health insurance or federal or State entitlement program.

Notes:

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 one year of the required experience.

DESIRED OR PREFERRED QUALIFICATIONS

The desired candidate should possess the following:
  • Experience working with federal or State entitlement programs
  • Experience with Medicaid programs
  • Experience analyzing and creating reports to inform members of the management team of the unit's productivity and performance metrics
  • Experience with Microsoft Office and Google Suite systems 
  • Experience conducting quality assurance analysis to ensure compliance with federal and State regulations and Department policies

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.




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