MEDICAL CARE PROGRAM SUPERVISOR

GRADE

17

LOCATION OF POSITION

MDH - Eligibility Determination Division 6 St. Paul Street Baltimore, MD 21202

Main Purpose of Job

The primary function of the Eligibility Determination Supervisor (Medical Care Program Supervisor) is to lead, manage and monitor the eligibility determinations and special projects workflows for their assigned Non-MAGI and/or MAGI Medicaid Unit(s) in a cohesive and ethical manner. Successful management and monitoring of the Unit(s) includes developing, analyzing, implementing, and applying federal and State regulations and policies, training materials, and standard operating protocols. This position must be able to develop and maintain electronic tools to track and assess data to monitor key performance indicators to identify workflow efficiencies and gaps to ensure compliance with federal and State regulations, improve operational performance, and monitor Eligibility Determination Lead Worker and Eligibility Determination Specialist (Medical Care Program Specialist I and/or II and Medical Care Program Associates I and/or II) overall performance. The Eligibility Determination Supervisor must continuously be knowledgeable of federal and State Medicaid regulations and policies. This knowledge is imperative to the Supervisor successfully being able to analyze eligibility determinations to ensure regulations and policies were interpreted and applied accurately and timely by Eligibility Determination Lead Workers, Specialist I and/or II, Associates I and/or II. The Supervisor’s quality assurance assessment must ensure the Eligibility Determination Lead Workers, Eligibility Determination Specialist I and/or II, and/or Associates I and/or II accurately analyzed and authenticated verifications including but not limited to applications, technical verifications, income, asset, resource, financial verifications, and clearances in the appropriate federal and state data systems for accuracy and timeliness compliance when rendering eligibility decisions. This knowledge is also required when the Supervisor is training Eligibility Determination Associates I and/or II or other internal customers, drafting Standard Operating Protocols (SOP), providing technical assistance, researching, and resolving provider payment concerns, serving as the Department’s expert witness at administrative appeals hearings or subject matter expert during systems development sessions. The Supervisor may participate in the administrative appeal hearing process by conducting pre-hearing conferences, providing expert testimony based on accurate analysis of federal and State regulations and policies at administrative appeals hearings and ensuring compliance to the Administrative Law Judge’s dispositions. Additionally, the Supervisor must be able to communicate concisely due to their contact with applicants, recipients, authorized representatives, or representatives from federal and State government entities to address concerns. At all times, this position will provide customer service to both internal and external customers that meet or exceed the standards by EDD, the Department, and or State. Travel throughout the state is required. The Medical Care Program Supervisor must maintain a valid driver’s license and meet the Department’s requirements to drive a state vehicle or have their own transportation when needed.

MINIMUM QUALIFICATIONS

Experience: Eight years of administrative or professional experience developing or applying policies and regulations in medical assistance, health insurance, federal or State entitlement programs. One year of this experience must have been in a medical assistance program. Notes: 1. Candidates may substitute the possession of a Bachelor's degree from an accredited college or university and four years of administrative or professional experience developing or applying policies and regulations in medical assistance, health insurance, federal or State entitlement programs for the required experience. One year of this experience must have been in a medical assistance program. 2. Candidates may substitute the possession of a Master’s degree from an accredited college or university in the related field of work for the required experience. 3. Candidates may substitute U.S. Armed Forces military service experience as a commissioned officer in Operational Analysis classifications or Health Services Management specialty codes in the health-related field of work on a year-for-year basis for the required experience.

DESIRED OR PREFERRED QUALIFICATIONS

The desired candidate should possess the following: Experience processing complex Medicaid eligibility applications. Experience working with consumers and other stakeholders resolving concerns. Experience with Home and Community Based Waivers, Long Term Care (LTC) Medicaid, and Earned Income Disallowance (EID) policies and regulations. Experience preparing cases including preparing concise hearing summaries and presenting Appeals before an Administrative Law Judge. Experience managing and training staff.

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

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. MDHMedCare