PROGRAM SPECIALIST (MEDICAL CARE PROGRAM SPECIALIST II)

Maryland; Baltimore (MD); Hybrid; USD 90,000 - 120,000; Full time

Job summary

Maryland Department of Health (MDH) Division of Hospice and PACE Services seeks a policy-focused administrator to support hospice enrollment, administrative processes, and stakeholder communication. Responsibilities include data gathering and analysis on Hospice services, monitoring providers for regulatory compliance, and advising management on improvements.

The role operates in a hybrid mode, with duties performed both remotely and on-site, subject to direction.

Qualifications

• Seven years of administrative or professional experience developing or applying policies and regulations in medical assistance, health insurance, federal or State entitlement programs.
• Bachelor’s degree plus three years of relevant experience can substitute for the required experience.
• Master’s degree may substitute for the required experience.

Responsibilities

• Support Maryland Medicaid Hospice program enrollment and administrative processes.
• Gather and analyze data on Hospice services.
• Monitor Hospice providers to ensure services meet federal/state regulations.
• Provide guidance and direction to Hospice providers; initiate corrective and improvement actions as needed.
• Make recommendations to management regarding corrective and innovative actions.

Skills

Policy development

Regulatory compliance

Health care administration

Education

Bachelor’s degree in related field

Master’s degree in related field

Job description

Introduction

* * * THIS RECRUITMENT IS LIMITED TO CURRENT MDH OFFICE OF LONG-TERM SERVICES AND SUPPORTS EMPLOYEES ONLY. * * *�

GRADE

STD0016

LOCATION OF POSITION

MDH - Division of Hospice and PACE Services

201 W. Preston Street�

Baltimore, MD 21201

Main Purpose of Job

The main purpose of this position is to support the Maryland Medicaid Hospice program enrollment, administrative processes, and stakeholder communication including general inquiries. Hospice is a fee-for-service program that provides services to terminally ill Medicaid participants. This position provides the following support: gathering and analyzing data on Hospice services; monitoring Hospice providers to ensure that medically necessary services are provided in accordance with federal and State regulations, policies, and standard medical practice; providing guidance and direction to Hospice providers; initiating corrective and improvement action as needed; and making recommendations to management regarding corrective and innovative actions.

This position operates in a hybrid manner, meaning job duties will be performed both remotely and on-site unless otherwise directed by the appointing authority.

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:

• 1. 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 therequired experience.
• 2. 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.
• 3. 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.

LIMITATIONS ON SELECTION

* * * THIS RECRUITMENT IS LIMITED TO CURRENT MDH OFFICE OF LONG-TERM SERVICES AND SUPPORTS EMPLOYEES ONLY. * * *

LICENSES, REGISTRATIONS AND CERTIFICATIONS

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

STATE OF MARYLAND BENEFITS

FURTHER INSTRUCTIONS

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.

MDHMedCare