MEDICAL CARE PROGRAM SPECIALIST II

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DHMH, Office of Inspector General, Baltimore, MD

The Medical Care Program Specialist II conducts independent and self directed investigations regarding recipient fraud, waste, and abuse for the Medical Assistance program. This position ensures that violations of Medicaid resources expended through Medicaid programs and services are investigated in accordance with The Affordable Care Act, State and Federal laws, regulations, and policies. This position will also be responsible for review of Maryland Medical Assistance cases and determine the accuracy of the Medicaid eligibility determinations through review, investigation, analysis, and reporting of eligibility results.

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

Experience: Three years of administrative or professional experience developing or applying policies and regulations in medical assistance, health insurance, federal or State entitlement programs.

Note:

1.  Additional administrative or professional experience applying policies and regulations in medical assistance, 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.  A Master's degree in the related field of work can be substituted for the required experience.

3. Candidates may substitute U.S. Armed Forces military service experience as a commissioned officer in Operational Analyst 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.

The preferred candidate should have working knowledge of Medicaid eligibility and have experience in Medicaid Fraud and recipient fraud.

Employees in this classification may be assigned duties which require the operation of a motor vehicle. Employees assigned such duties may be required to possess a motor vehicle operator's license valid in the State of Maryland.

Applicants who meet the minimum qualifications will be evaluated.  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.  For education obtained outside the U.S., a copy of the equivalent American education as determined by a foreign credential evaluation service must accompany the application.  All information concerning your qualifications must be submitted by the closing date.  We will not consider information submitted after this date.  Applicants certified to list will receive eligibility for a period of one (1) year.  Eligibility may be extended beyond one (1) year period.

Online applications are highly recommended, however the paper application may be submitted to DHMH, Recruitment and Selection Division, 201 W. Preston St., Room 114-B, Baltimore, MD 21201.  The paper application must be received by 5 pm, close of business, on the closing date for the recruitment, no postmarks will be accepted.

Incorrect application forms will not be accepted.

If you need to submit additional information, the preferred method is to upload.  If unable to upload, please fax requested information only to 410-333-5689.

Should additional information regarding this recruitment be required, please contact the DHMH Recruitment and Selection Division at 410-767-1251 or via email at dhmh.jobs@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.

The incumbent in this position is a member of a covered bargaining unit and will be required to pay a bi-weekly service fee to the exclusive representative of the bargaining unit.

STATE OF MARYLAND BENEFITS

As an equal opportunity employer, Maryland is committed to recruiting, retaining and promoting employees who are reflective of the State’s diversity.

The resulting certified eligible list for this recruitment may be used for similar positions in this or other State agencies.

We thank our Veterans for their service to our country, and encourage them to apply.

Bilingual applicants are encouraged to apply.