MEDICAL CARE PROGRAM ASSOCIATE III

State of Maryland; Maryland; On-site; USD 47,000 - 65,000; Full time

Job summary

State of Maryland is seeking a detail-oriented supervisor for the HealthChoice Enrollment Unit in Baltimore. The role leads paraprofessional staff, trains associates, and ensures accurate processing of enrollment, disenrollment, and related changes.

The position requires strong knowledge of Med­icaid policies, experience with MMIS/HBX/E+E systems, and ability to coordinate with MCOs. Applicants should demonstrate data integrity and effective collaboration.

Qualifications

• Graduation from an accredited high school or possession of a high school equivalency certificate.
• Three years of clerical experience applying policies in a medical care, health insurance or federal or State entitlement program.
• Notes: substitutions allowed—additional clerical experience or 30 college credits for one year of experience.

Responsibilities

• Lead paraprofessional staff in the HealthChoice Enrollment Unit and train associates.
• Assign, review, and approve daily enrollment work.
• Process online enrollment files, MCO additions, changes, withdrawals, and corrections.
• Independently verify the validity of enrollment and disenrollment transactions before data entry.
• Liaise with Managed Care Organizations (MCOs) for capitation payments and special programs.
• Identify and resolve problems from providers, MCOs and external stakeholders using policy knowledge.

Skills

Leadership

Coaching

Communication

Conflict resolution

Medicaid regulations interpretation

Education

High school diploma or GED

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: Candidates may substitute additional general clerical experience on a year-for-year basis for the required education. Candidates may substitute thirty credit hours from an accredited college or university for one year of the required experience.

Desired or Preferred Qualifications

The desired candidate should possess the following:

• 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. 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.

We thank our Veterans for their service to our country.

People with disabilities and bilingual candidates are encouraged to apply.

Appropriate accommodations for individuals with disabilities are available upon request by calling: 410-767-1251 or MD TTY Relay Service 1-800-735-2258.

As an equal opportunity employer, Maryland is committed to recruitment, retaining and promoting employees who are reflective of the State's diversity.