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MEDICAL CARE PROGRAM SUPERVISOR

Recruitment #17-000931-0002

GRADE

16

LOCATION OF POSITION

Department of Health and Mental Hygiene, Office of Health Services, Baltimore, MD

Main Purpose of Job

The main purpose of this position is the administration of the Hospital Services Program Section within the Division of Hospital, HealthChoice and Acute Care Administration (HACA). This position oversees program policy for the acute hospitals, ensures quality of care for Medicaid recipients receiving hospital services, assists in overseeing the Utilization Control Agent (UCA) and ensures compliance with State and federal regulations for acute general hospital services. This position will ensure the appropriateness of an inpatient hospital stay, as well as ensuring the inpatient stay is medically necessary. This position is responsible for the reconciliation of the UCAs invoices on a monthly basis. This position reviews and tracks administrative appeals from the hospitals, and directly supervises a staff that consists of: one contractual medical review nurse and two medical care program specialists.

MINIMUM QUALIFICATIONS

Education: A Bachelor’s degree from an accredited college or university.

Experience: Four years of administrative or professional experience developing or applying policies and regulations in medical assistance, health insurance, federal or State entitlement programs. One year of this experience must have been in a medical assistance program.

Note: 1. Additional administrative or professional experience developing or applying policies and regulations in medical assistance, health insurance, federal or State entitlement programs or in a health or human service program may be substituted on a year-for-year basis for the required education.

2.  A Master's degree in the related field of work can be substituted for the required experience.

3. Candidates may substitute U.S. Armed Forces military service experience as a commissioned officer in Operational Analyst classifications or Health Services Management specialty codes in the health related field of work on a year-for-year basis for the required experience and education.

LICENSES, REGISTRATIONS AND CERTIFICATIONS

Employees in this classification may be assigned duties which require the operation of a motor vehicle. Employees assigned such duties will be required to possess a motor vehicle operator’s license valid in the State of Maryland.

SELECTION PROCESS

Applicants who meet the minimum qualifications will be evaluated.  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.  For education obtained outside the U.S., a copy of the equivalent American education as determined by a foreign credential evaluation service must accompany the application.  All information concerning your qualifications must be submitted by the closing date.  We will not consider information submitted after this date.  Applicants certified to list will receive eligibility for a period of one (1) year.  Eligibility may be extended beyond one (1) year period.

Online applications are highly recommended, however the paper application may be submitted to DHMH, Recruitment and Selection Division, 201 W. Preston St., Room 114-B, Baltimore, MD 21201.  The paper application must be received by 5 pm, close of business, on the closing date for the recruitment, no postmarks will be accepted.

Incorrect application forms will not be accepted.

If you need to submit additional information, the preferred method is to upload.  If unable to upload, please fax requested information only to 410-333-5689.

Should additional information regarding this recruitment be required, please contact the DHMH Recruitment and Selection Division at 410-767-1251 or via email at dhmh.jobs@maryland.gov

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

BENEFITS

FURTHER INSTRUCTIONS

As an equal opportunity employer, Maryland is committed to recruiting, retaining and promoting employees who are reflective of the State’s diversity. People with disabilities and bilingual candidates are encouraged to apply. We thank our Veterans for their service to our country.

The resulting certified eligible list for this recruitment may be used for similar positions in this or other State agencies.




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