Medicaid Policy Lead - Eligibility & Appeals

JobAps; Baltimore, Northern (MD, KY); Hybrid; USD 75,000 - 110,000; Full time

Job summary

JobAps is seeking a supervisor for the Eligibility Policy Unit to manage Non-MAGI Medicaid policy at the Maryland Department of Health in Baltimore. The role includes coordinating complex casework, waivers, and investigations in collaboration with MDH offices.

The candidate should have extensive policy experience, strong written communication, and analytical skills to interpret Medicaid rules and ensure compliance across MAGI and Non-MAGI programs.

Qualifications

• 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.
• Candidates may substitute a Bachelor's degree from an accredited college or university and four years of related experience for the required experience.
• Candidates may substitute 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.

Responsibilities

• Supervise the Eligibility Policy Unit for Non-MAGI Medicaid policy.
• Respond to inquiries on Non-MAGI and MAGI cases on behalf of MDH.
• Coordinate advanced casework activities (PEMEs), waivers, overdue cases, and referrals to OIG/AG for fraud, overpayments, and appeals.

Skills

Medicaid policy knowledge

Written communication

Analytical thinking

Education

Bachelor's degree

Master’s degree

Job description

JobAps is seeking a supervisor for the Eligibility Policy Unit to manage Non-MAGI Medicaid policy at the Maryland Department of Health in Baltimore. The role includes coordinating complex casework, waivers, and investigations in collaboration with MDH offices.

The candidate should have extensive policy experience, strong written communication, and analytical skills to interpret Medicaid rules and ensure compliance across MAGI and Non-MAGI programs.