DIRECTOR, OFFICE OF ELIGIBILITY SERVICES

GRADE

25

LOCATION OF POSITION

MDH Office of Health Care Financing, Baltimore MD

Main Purpose of Job

The main purpose of this position is to supervise and manage the Office of Eligibility Services (OES) within the Health Care Financing & Medicaid Administration, helping to ensure that Marylanders receive efficient and accurate eligibility services. This role is responsible for overseeing the eligibility operations, systems, regulation and policy, and staff for Medicaid, Maryland Children’s Health Insurance Program (MCHP), and other Medical Assistance Programs. This position directs the implementation and continuous improvement of eligibility operations, including policy development, system functionality, and eligibility caseworker training programs. This work crosses the Maryland Health Benefits Exchange, Department of Human Services, and local health departments. The Director is also responsible for maintaining strong operational performance standards that ensure eligibility and frontline staff effectively support Marylanders as they enroll in and renew coverage. Key operational responsibilities include overseeing the development, implementation, and maintenance of eligibility operations, regulations, and policies under the Code of Maryland Regulations (COMAR). This role also involves leading the design and delivery of statewide eligibility training and technical assistance programs for eligibility case workers across the Maryland Department of Health, local health departments, the Department of Human Services, and the Maryland Health Benefit Exchange. Additional responsibilities include ensuring the accuracy, integrity, and operational functionality of the master eligibility file and supporting the Medicare Part B Buy-In program. The position also manages the issuance of Medical Assistance identification cards and related customer service processes, oversees eligibility determinations for specialized programs such as Home and Community-Based Services (HCBS) waivers, and implements operational improvements that enhance efficiency, accuracy, and member satisfaction. Functional leadership responsibilities include supervising and developing OES staff to strengthen operational execution and service excellence, as well as serving as a liaison with state and federal partners to coordinate eligibility operations and resolve recipient issues. The role also includes providing legislative testimony and supporting executive decision-making through operational data and analysis. Additionally, the position collaborates with CMS and internal technical groups, including the Medical Assistance Advisory Committee and the MCO rate setting workgroup to align eligibility operations with broader program goals.

MINIMUM QUALIFICATIONS

Qualified candidates must possess a bachelor's degree from an accredited college or university and six years of experience in large-scale program administration, operations, or change management, preferably in health care, Medicaid, or eligibility programs. A minimum of three years at a supervisory or management level is also required. Qualifying supervisory experience must include leading complex, broad-scope organizational or operational change in one or more of the following areas: healthcare administration, government program operations, or eligibility systems management. Familiarity with Medicaid programs, Medical Assistance eligibility determination, or related policy and regulatory frameworks is strongly preferred. A Master's degree is preferred and will substitute for one year of general experience. A Doctorate will substitute for two years of general experience.

DESIRED OR PREFERRED QUALIFICATIONS

The desired candidate should possess the following:  Extensive experience managing large-scale eligibility or public benefits operations, ideally within Medicaid, health coverage, or other human services programs.  Proven leadership in operational management, including overseeing staff, performance, workflow, and service delivery systems.  Experience improving customer service systems and processes, with a focus on member experience, accessibility, and efficiency.  Strong understanding of eligibility policy, systems, and regulations, including how policy changes translate into operational implementation.  Experience coordinating across multiple agencies or partners, such as human services departments, health exchanges, or IT system vendors.  Background in training and workforce development, ensuring consistent understanding and application of eligibility policies statewide.  Demonstrated ability to use data and performance metrics to manage operations, improve accuracy, and enhance customer satisfaction.  Familiarity with federal and state Medicaid requirements, including reporting, compliance, and quality standards.

SELECTION PROCESS

This is a Management Service position and serves at the pleasure of the Appointing Authority. A resume is required and must be uploaded to your application. While cover letters are not mandatory, if you choose to include one, please upload it together with your resume as a single file. 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. 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

STATE OF MARYLAND 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.