MEDICAL CARE PROGRAM ASSOCIATE III

Maryland; Baltimore (MD); On-site; USD 42,000 - 64,000; Full time

Job summary

The Maryland Department of Health seeks a senior enrollment supervisor in Baltimore to lead paraprofessional staff within the HealthChoice Enrollment Unit. You will train Medical Care Program Associates and oversee daily assignments, reviews, and approvals of enrollment and disenrollment tasks.

You will also process online files, manage MCO relationships, verify eligibility, and address issues raised by providers and external stakeholders using established enrollment policies.

Qualifications

• High school graduation or equivalency.
• Three years clerical experience in medical care, health insurance, or entitlement programs.

Responsibilities

• Lead paraprofessional staff in the HealthChoice Enrollment Unit.
• Train Medical Care Program Associates and oversee daily assignments, reviews, and approvals.
• Process online files, MCO additions, changes, withdrawals, and corrections.
• Liaise with Managed Care Organizations to verify enrollment and disenrollment activities.

Skills

Interpersonal skills

Organizational skills

Coaching

Communication

Conflict resolution

Education

High school diploma

Tools

MMIS

HBX

E+E

Job description

Introduction

* * * THIS RECRUITMENT IS LIMITED TO CURRENT MARYLAND DEPARTMENT OF HEALTH EMPLOYEES ONLY. * * *

GRADE

ASTD12

LOCATION OF POSITION

MDH - Office of Eligibility Services
201 W. Preston Street
Baltimore, MD 21201

Main Purpose of Job

The main purpose of this position is to lead paraprofessional staff in the HealthChoice Enrollment Unit, which includes the training of Medical Care Program Associates and the assigning, reviewing, and approval of their daily work. This position is responsible for processing on-line files, MCO additions, changes, withdrawals, and corrections, including independent verification of the validity of enrollment and disenrollment transactions prior to data entry. This position provides liaison services to the Managed Care Organizations (MCOs) to include but not limited to special capitation payments, recipient eligibility for enrollment in special programs, and verification of validity of enrollment and disenrollment activities. This position identifies and resolves problems presented by medical care providers, MCOs and their staff members and various external stakeholders using knowledge of established policies that govern enrollment and disenrollment procedures. This position requires a thorough knowledge and demonstrated application of Medical Assistance policies, regulations, and guidelines; and requires the exercise of discretion and independent judgment in making decisions and interpreting and applying policies, procedures, and regulations.

MINIMUM QUALIFICATIONS

• Education:Graduation from an accredited high school or possession of a high school equivalency certificate.
• Experience: Three years of clerical experience applying policies in a medical care, health insurance or federal or State entitlement program.
• Notes:
• 1. Candidates may substitute additional general clerical experience on a year-for-year basis for the required education.
• 2. Candidates may substitute thirty credit hours from anaccredited college or university for one year of the requiredexperience.

DESIRED OR PREFERRED QUALIFICATIONS

• Experience directing staff, overseeing work accuracy and timeliness, and coaching team members to achieve program goals
• Experience interpreting and analyzing Medicaid regulations, policies, and procedures
• Experience utilizing data systems such as MMIS, HBX, and E+E
• Strong organizational skills
• Excellent interpersonal skills, emphasizing communication and conflict resolution

LIMITATIONS ON SELECTION

* * * THIS RECRUITMENT IS LIMITED TO CURRENT MARYLAND DEPARTMENT OF HEALTH EMPLOYEES ONLY. * * *

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.

BENEFITS

STATE OF MARYLAND BENEFITS

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.

We thank our Veterans for their service to our country.

MDHMedCare