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DEPUTY DIRECTOR, PROGRAM OPERATIONS

PROGRAM MANAGER III

Recruitment #17-005478-0025

GRADE

21

LOCATION OF POSITION

MDH, Office of Systems, Operations and Pharmacy, Baltimore, MD

Main Purpose of Job

The main purpose of this position is to serve as the Deputy Director for Program Operations. This position oversees the operations of the following divisions: 1.) Provider Relations, which responds to provider inquiries on claims status, and offers assistance in billing, providing training when necessary; 2.) Claims Processing, which enables payment of all providers of service; 3.) Provider Services and Reference System which enrolls Medicaid providers into the program, maintains HCPCS, CPT, ICD-10 codes; 4.) Adjustments and Payment Auditing, which handles all claims adjustments i.e. gross, mass provider communications; 5.) Medical Assistance Division of Recoveries and Financial Services, which maximizes the amount of funds recovered and expenditures avoided under State and Federal regulations; 6.) Long Term Care Problem Resolution, which handles all institutions inquiries and claims from providers.

MINIMUM QUALIFICATIONS

Qualified candidates must possess a bachelor's degree and three years of experience for a Commercial/Government Health Insurance Payor or Healthcare Provider and three years of managing multiple divisions concurrently.

Qualified candidates should also possess a strong background in resolving Medical Claims issues and working with Healthcare Providers; experience with medical forms including CMS1500 and UB04; and, knowledge of third party insurance.

Additional management experience may be substituted on a year for year basis for the Educational requirement.

SELECTION PROCESS

This is a Management Service position, and serves at the pleasure of the Appointing Authority.  A resume must accompany your application.

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.

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.

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.