Medical Care Program Associate III

MDH Med Care Prgms - Office of Eligibility Svcs; Baltimore (MD); On-site; USD 55,000 - 85,000; Full time

Job summary

Maryland Department of Health – Office of Eligibility Services seeks a Medical Care Program Associate III to lead paraprofessional staff in the HealthChoice Enrollment Unit. The role processes online enrollment files, manages MCO transactions, verifies enrollment validity and resolves issues raised by medical providers and stakeholders.

The ideal candidate has thorough knowledge of Medical Assistance policies, strong organizational and interpersonal skills, and the ability to interpret

Qualifications

• High school diploma or equivalency.
• 3 years of clerical experience applying policies in medical care, health insurance, or entitlement programs.
• Experience directing staff and overseeing work accuracy.
• Experience interpreting and analyzing Medicaid regulations and policies.
• Experience with data systems such as MMIS, HBX, and E+E; strong organizational and interpersonal skills.

Responsibilities

• Lead paraprofessional staff in the HealthChoice Enrollment Unit.
• Process online enrollment files and verify enrollment validity.
• Manage MCO transactions and resolve issues for providers and stakeholders.

Skills

Staff supervision

Policy interpretation

Medicaid policy analysis

Organizational skills

Interpersonal skills

Clerical experience

Education

High school diploma or equivalency certificate

Tools

MMIS/HBX/E+E systems

Job description

The Medical Care Program Associate III leads paraprofessional staff in the HealthChoice Enrollment Unit of the Maryland Department of Health's Office of Eligibility Services. The position processes online enrollment files, manages MCO transactions, verifies enrollment validity, and resolves problems presented by medical providers and stakeholders. This role requires thorough knowledge of Medical Assistance policies and the ability to exercise discretion in interpreting and applying regulations.

Key qualifications:

• High school diploma or equivalency certificate
• Three years of clerical experience applying policies in medical care, health insurance, or state/federal entitlement programs
• Experience directing staff and overseeing work accuracy
• Experience interpreting and analyzing Medicaid regulations and policies
• Experience with data systems such as MMIS, HBX, and E+E
• Strong organizational and interpersonal skills