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#17-005484-0006
Supplemental Questionnaire

Last Name
First Name

 

Please note that your answer on the supplemental questionnaire must correspond to the information that is provided on your resume to receive credit.


1

Do you possess a Master's Degree from an accredited college or university?

Yes No
2

What field of study is your master's degree in?

3

Do you possess a bachelor's degree from an accredited college or university in business, communications, or a mathematics related major?  If so, please indicate field of study in the box below.  If no, please write N/A.

4

What is the major field of study for your bachelor's degree? If you answered "No" to the previous question, please enter N/A in the box.

5

Describe your experience leading and managing programmatic and administration/ operations in an organization which provides health services in behavioral health care.  Work experience must include planning, developing, and implementing health service delivery models of care; work with clinical outcomes; and data collection, analysis (qualitative and quantitative) and presentation.

Please include name of employer, job title, dates of employment, and hours worked per week, this information must also be reflected in your application.  If you do not possess experience in this area, put N/A in the box below.

6

Describe your experience with program management and direct supervision of staff.

Please include name of employer, job title, dates of employment, and hours worked per week, this information must also be reflected in your application.  If you do not possess experience in this area, put N/A in the box below.

7

Describe your knowledge of Maryland's public behavioral health system of care including inpatient psychiatric services, core service agencies and community providers, substance use disorders, managed care and quality improvement. 

Please include name of employer, job title, dates of employment, and hours worked per week, this information must also be reflected in your application.  If you do not possess experience in this area, put N/A in the box below.

8

Describe your experience in program development, program planning, research and evaluation, and senior level policy making.

Please include name of employer, job title, dates of employment, and hours worked per week, this information must also be reflected in your application.  If you do not possess experience in this area, put N/A in the box below.

9

Describe your knowledge of Medicaid and building workflows required to support a behavioral health claims based system.

Please include name of employer, job title, dates of employment, and hours worked per week, this information must also be reflected in your application.  If you do not possess experience in this area, put N/A in the box below.


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