What are the responsibilities and job description for the MEDICAL CARE PROGRAM SPECIALIST II QUALITY CONTROL ANALYST (FULL-TIME CONTRACTUAL) position at State of Maryland?
Introduction GRADE
16
LOCATION OF POSITION
MDH - Office of Eligibility Services - MEQC Unit
201 W. Preston Street
Baltimore, MD 21201
Main Purpose of Job
The main purpose of this full-time contractual position is to conduct field audits, investigate, analyze and evaluate Medicaid Eligibility program decisions processed by eligibility technicians and reviewed by eligibility supervisors, at the Local Departments of Social Services (LDSS) under the Department of Human Services (DHS), the Local Health Departments (LHD) under the Maryland Department of Health (MDH), and various agents in operation of the Maryland Health Connection (MHC), in order to ensure that such determinations are accurate and in compliance with all Federal and State regulations and policies. This process informs Directors of LDSS and LDH, Family Investment Administration (FIA) central leadership at DHS, Medical Care Programs administration at MDH, Maryland legislative leadership and Federal administration in the Center for Medicare and Medicaid Systems (CMS), about the accuracy and timeliness of benefit processing and identifies corrective action(s) needed to prevent future errors.
MDH is charged by CMS with the responsibility of managing the State Medicaid Program and uses this position to achieve its goal of payment accuracy and the effective and efficient administration of the Title XIX programs by DHS. Detailed and informative reports are prepared for all levels of Federal, State and Local management by applying accepted management techniques and methods to identify, explain and resolve systems, policy, procedural and administrative problems.
Minimum Qualifications
Experience: Seven years of administrative or professional experience developing or applying policies and regulations in medical assistance, health insurance, federal or State entitlement programs.
Notes
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.
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
Contractual employees who work for an agency covered under the State Employee and Retiree Health and Welfare Benefits Program, have a current employment contract and work 30 or more hours a week (or on average 130 hours per month) may be eligible for subsidized health benefits coverage for themselves and their dependents. As a contractual employee, you will be responsible for paying 25% of the premiums for your medical and prescription coverage, including any eligible dependents you have enrolled. The State of Maryland will subsidize the remaining 75% of the cost for these benefits. You can also elect to enroll in dental coverage, accidental death and dismemberment insurance, and life insurance, but will be responsible to pay the full premium for these benefits.
Leave may be granted to a contractual employee who has worked 120 days in a 12 month period. This leave accrues at a rate of one hour for every 30 hours worked, not to exceed 40 hours per calendar year.
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.
16
LOCATION OF POSITION
MDH - Office of Eligibility Services - MEQC Unit
201 W. Preston Street
Baltimore, MD 21201
Main Purpose of Job
The main purpose of this full-time contractual position is to conduct field audits, investigate, analyze and evaluate Medicaid Eligibility program decisions processed by eligibility technicians and reviewed by eligibility supervisors, at the Local Departments of Social Services (LDSS) under the Department of Human Services (DHS), the Local Health Departments (LHD) under the Maryland Department of Health (MDH), and various agents in operation of the Maryland Health Connection (MHC), in order to ensure that such determinations are accurate and in compliance with all Federal and State regulations and policies. This process informs Directors of LDSS and LDH, Family Investment Administration (FIA) central leadership at DHS, Medical Care Programs administration at MDH, Maryland legislative leadership and Federal administration in the Center for Medicare and Medicaid Systems (CMS), about the accuracy and timeliness of benefit processing and identifies corrective action(s) needed to prevent future errors.
MDH is charged by CMS with the responsibility of managing the State Medicaid Program and uses this position to achieve its goal of payment accuracy and the effective and efficient administration of the Title XIX programs by DHS. Detailed and informative reports are prepared for all levels of Federal, State and Local management by applying accepted management techniques and methods to identify, explain and resolve systems, policy, procedural and administrative problems.
Minimum Qualifications
Experience: Seven years of administrative or professional experience developing or applying policies and regulations in medical assistance, health insurance, federal or State entitlement programs.
Notes
- Candidates may substitute the possession of a Bachelor's degree from an accredited college or university and three 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.
- 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.
- 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.
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.
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
Contractual employees who work for an agency covered under the State Employee and Retiree Health and Welfare Benefits Program, have a current employment contract and work 30 or more hours a week (or on average 130 hours per month) may be eligible for subsidized health benefits coverage for themselves and their dependents. As a contractual employee, you will be responsible for paying 25% of the premiums for your medical and prescription coverage, including any eligible dependents you have enrolled. The State of Maryland will subsidize the remaining 75% of the cost for these benefits. You can also elect to enroll in dental coverage, accidental death and dismemberment insurance, and life insurance, but will be responsible to pay the full premium for these benefits.
Leave may be granted to a contractual employee who has worked 120 days in a 12 month period. This leave accrues at a rate of one hour for every 30 hours worked, not to exceed 40 hours per calendar year.
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.
