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MEDICAL CARE PROGRAM SPECIALIST II

Recruitment #17-000928-0017

GRADE

15

LOCATION OF POSITION

MDH, Office of Health Services, Baltimore, MD

Main Purpose of Job

The Program specialists will develop and apply Medical Assistance policies and regulations for the Community Personal Assistance Services, Community First Choice, Increased Community Services, and Home and Community-based Options waiver programs.

Specialists verify eligibility and enroll participants, verify credentials and enroll providers, provide support to enrolled providers, acting as a liaison with participants, providers, and supports planners in issues related to policy and regulations for the programs. Specialists will also perform audits of provider claims, investigate billing issues, and resolve problems related to enrollment. Specialists monitor utilization and compliance with program rules.

Specialists will also interpret and apply policy and regulations for participants, providers, and other partners, acting as a liaison for the Department, communicating guidance, developing and conducting training, and offering consultation and technical assistance to both participants and providers of the aforementioned programs. Specailists provide guidance to support staff and other personnel of the Department regarding the programs.

Specialists will provide support in coordianting the Community Options Advisory Council and will represent the Department in meetings and in telephone contacts with advocates, providers and participants.

MINIMUM QUALIFICATIONS

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.

DESIRED OR PREFERRED QUALIFICATIONS

Candidate should have experience reviewing health care data and developing Medical Assistance policies related to critical incident reports.

LICENSES, REGISTRATIONS AND CERTIFICATIONS

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.

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. Candidates may remain on the certified eligible list for a period of at least one year.

Online applications are highly recommended. However, if you are unable to apply online, the paper application may be submitted to MDH, 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 additional information is required, the preferred method is to upload.  If unable to upload, please fax requested information only 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.

Resumes will not be accepted in lieu of a completed application.

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.

BARGAINING UNIT STATUS

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.

BENEFITS

FURTHER INSTRUCTIONS

As an equal opportunity employer, Maryland is committed to recruiting, retaining and promoting employees who are reflective of the State’s diversity. People with disabilities and bilingual candidates are encouraged to apply. We thank our Veterans for their service to our country.

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




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