Introduction

* * * THIS RECRUITMENT IS LIMITED TO CURRENT MDH OFFICE OF MEDICAL BENEFITS MANAGEMENT EMPLOYEES ONLY. * * *

GRADE

20

LOCATION OF POSITION

MDH - Office of Medical Benefits Management
201 W. Preston Street

Baltimore, MD 21201

Main Purpose of Job

This position serves as the Chief for the Division of Hospital Services within the HealthChoice and Acute Care Administration (HACA) of the Maryland Medical Assistance Program. This position is responsible for Program policy, oversight, compliance and reimbursement for Inpatient and Outpatient hospital services in Maryland, the District of Columbia and Out-of-State Hospitals in the Medicaid Program. This Division is responsible for monitoring the acute hospital portion of the federally mandated Utilization Control Agent's (UCA) contract to ensure that Medicaid enrollees receive medically necessary and appropriate services. The UCA contract includes determination of inpatient needs, length of stay and medical appropriateness in acute care hospitals. This Division is responsible for conducting acute hospital appeals, reviewing requests for transplants and out-of-state acute hospitalizations. The Division Chief is responsible for managing a team of professionals including one supervisor, nurses and administrative staff. Additionally, this position plans and provides direction and oversight for one Supervisor who oversees certain aspects of the hospital program and is a Medical Care Program Supervisor and directly supervises Medical Care Program Specialists and contractual review nurses.

This position requires constant monitoring and evaluation of services provided by hospitals located in Maryland, the District of Columbia and Out-of-State to ensure compliance with Federal and State laws. Administering the needs of this program includes creating and maintaining rate setting functions that are coordinated with Beacon Health Options (the Administrative Service Organization for Behavioral Health and Substance Use Disorder), the MCOs, and personnel within the Office of Finance.

MINIMUM QUALIFICATIONS

Education: Graduation from an accredited high school or possession of a high school equivalency certificate.

Experience: Six years of administrative staff or professional work.

Notes:

1. Candidates may substitute 30 credit hours from an accredited college or university for each year up to four years of the required experience.

2. Candidates may substitute the possession of a Bachelor's degree from an accredited college or university and two years of experience in administrative staff or professional work for the required experience.

3. Candidates may substitute the possession of a Master's degree from an accredited college or university for five years of the required experience.

4. Candidates may substitute U.S. Armed Forces military service experience as a commissioned officer involving staff work related to the administration of rules, regulations, policy, procedures and processes, or overseeing or coordinating unit operations or functioning as a staff assistant to a higher ranking commissioned officer on a year-for-year basis for the required experience.

DESIRED OR PREFERRED QUALIFICATIONS

The desired candidate should possess the following:

• Experience analyzing research from a quantitative and qualitative perspective to support strategic policy and program development.
• Knowledge of applicable state and federal laws, regulations and requirements.
• Experience working independently and as part of a team.
• Ability to notice and react to trends.
• Ability to lead a team.

LIMITATIONS ON SELECTION

* * * THIS RECRUITMENT IS LIMITED TO CURRENT MDH OFFICE OF MEDICAL BENEFITS MANAGEMENT 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 will 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

Online applications are highly recommended. However, if you are unable to apply online, the paper application (and supplemental questionnaire) may be submitted to MDH, Recruitment and Selection Division, 201 W. Preston St., Room 114-B, Baltimore, MD 21201. Paper application materials must be received by 5 pm, close of business, on the closing date for the recruitment, no postmarks will be accepted.

If additional information is required, the preferred method is to upload. If you are unable to upload, please fax the requested information to 410-333-5689. Only additional materials that are required will be accepted for this recruitment. All additional information must be received by the closing date and time.

For questions regarding this recruitment, please contact the MDH Recruitment and Selection Division at 410-767-1251.

If you are having difficulty with your user account or have general questions about the online application system, please contact the MD Department of Budget and Management, Recruitment and Examination Division at 410-767-4850 or [email protected].