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HEALTH POLICY ANALYST ADVANCED

ELIGIBILITY DETERMINATION TRAINING SPECIALIST

Recruitment #25-002420-0001

Introduction

GRADE

19

LOCATION OF POSITION

MDH - Eligibility Determination Division
201 W. Preston Street
Baltimore, MD 21201

Main Purpose of Job

The Medicaid Eligibility Services Trainer is responsible for evaluating, analyzing, researching, developing and implementing training services and materials (including manuals and standard operating procedures) for the Eligibility Determination Division (EDD) of the Office of Eligibility Services (OES). This role ensures that employees are knowledgeable about policies, regulations, and best practices to provide accurate and effective determinations to applicants, participants and clients.

In coordination with internal (Office of Long Term Services & Supports, Developmental Disabilities Administration) and external (DHS, MHBE, MDOD, MSDE, MDOA, DPSCS, DJS, DHCD and other agencies) Medicaid eligibility determinations are rendered in accordance with federal and State regulations, policies and procedures within EDD Divisions: 

1) Division of Home and Community-Based Services (HCBS) waivers, Long Term Care (LTC), and Disabilities Medicaid consist of five units that determine initial eligibility, redetermination eligibility and case maintenance activities in compliance with federal and State regulations for twelve statewide Medicaid waivers and programs in the Eligibility and Enrollment (E&E) System on the MDThink platform. Seven are 1915(c) HCBS waivers, one 1915(b)(4), and four Medicaid programs that follow the Aged, Blind, and Disabled (ABD) regulations approved by the Centers for Medicaid and Medicare Services. Medicaid waivers and programs provide medically necessary services to Maryland's constituents that prefer to receive Long Term Services and Supports in their home or community, rather than in an institutional setting. 

2) Division of Medicaid Adjusted Gross Income (MAGI), Maryland Children Health Program (MCHP), Special Projects Medicaid and Inmate Outreach Project, and Problem Resolution/Special Projects Medicaid consist of five units that provide statewide enhanced eligibility and enrollment assistance to Maryland residents applying for Medicaid in the Maryland Health Connection (MHC). The five units also research and resolve Medicaid recipient span concerns that have prevented providers from being paid. These units are responsible for verifying initial and continuing eligibility, interim changes and resolving Medicaid span discrepancies that have prevented providers from being paid for: 

 * Undocumented/Unqualified Immigrants Emergency Medical Services (402, Х03)
 * Justice Involved 1115 Inmate services for incarcerated individuals transitioning from Maryland's criminal justice centers, and families and children. 
 * One of the five units includes the Problem Resolution Unit (PRU) which is responsible for investigating and resolving complex and escalated cases from constituents, other Maryland   Department of Health (MDH) divisions, State agencies or offices, advocacy groups, and providers. 

3) Division of Quality, Compliance and Systems, manages appeals, quality assurance, program and system compliance, special projects, data reporting and security monitoring for the Maryland Health Connection (MHC), MDTHINK Eligibility and Enrollment, (E&E), and Medicaid Management Information System (MMIS). This Division is composed of four units that support the MAGI and Non-MAGI Units identified in 1 and 2. The Appeals Unit represents EDD at hearings before an Administrative Law Judge for HCBS waivers. The Data Reporting and Security Monitoring Unit ensures EDD employees have appropriate equipment and access to systems required to determine eligibility and resolve data discrepancies that require manual updating in MMIS. The Eligibility Call Center Hotlines assist Medicaid applicants/recipients with resolving concerns and answering Medicaid eligibility questions, processing verifications for applicants/recipients applying for Medicaid in the Maryland Health Connection (MHC) and assisting with resolving eligibility span discrepancies that prevent Medicaid providers from being paid. The Support Intake & Distribution Unit ensures timely intake and distribution of applications, verifications and correspondences, including data entry, scanning and printing and mailing correspondence and notices to ensure program integrity, and timely processing of applications.

MINIMUM QUALIFICATIONS

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

Experience: Three years of experience evaluating, analyzing, researching and developing health care services, policies and programs.

Notes:

1. Candidates may substitute the possession of a Master's degree in Health Sciences, Health Care Administration, Public Health, Public Policy or closely related field for one year of the required experience.

2. Candidates may substitute the possession of a Doctorate degree in Health Sciences, Health Care Administration, Public Health, Public Policy or closely related field for two years of the required experience.

DESIRED OR PREFERRED QUALIFICATIONS

The desired candidate should possess the following:
  • Experience designing training materials and interactive learning experiences to support performance goals.
  • Professional experience delivering training to diverse audiences in various formats (in-person, virtual, one-on-one, and group).  
  • Experience working with federal or state regulations, policies, or procedures, with a focus on analysis and application.  
  • Experience conducting training on Non-MAGI and/or MAGI policy.  
  • Experience developing presentations using PowerPoint and other tools.  
  • Experience with policy research and technical writing.  
  • Experience creating engaging, hands-on training programs.

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.




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