Deputy Director, Office Of Eligibility Services

State of Maryland•Baltimore City, MD

4d•Hybrid

About The Position

The Deputy Director is the sole deputy for the Maryland Department of Health’s Office of Eligibility Services (OES). The role plans, directs, supervises, administers, and evaluates three sub-directorates: Eligibility Determination; Eligibility Policy and Operations; and Systems Reconciliation, Program Integrity, Information Analysis and Monitoring. The Deputy Director provides quality oversight of financial eligibility determinations for Medicaid 1915(c) Home and Community-Based Services waiver programs and ensures that operations comply with federal and State requirements. The position also leads statewide Medicaid eligibility policy, training, and beneficiary enrollment, as well as program integrity and reconciliation of eligibility information technology systems. The sub-directorates support eligibility policy and operations for MAGI and non-MAGI populations. The Deputy Director establishes program policies, procedures, goals, standards, and controls; oversees implementation and evaluates effectiveness; approves major revisions; manages personnel and financial resources; and plans, coordinates, supervises, and evaluates subordinate managers. The position develops short- and long-range plans, determines organizational structure and staffing needs, and oversees staff training. It represents the agency before federal, State, and local officials, legislative committees, and senior officials of other agencies. The role participates in Medicaid eligibility reform planning and readiness and works with the Centers for Medicare and Medicaid Services and the Maryland Health Benefit Exchange on eligibility compliance and program integrity. The Deputy Director reports directly to the Director of OES and may act for the Director when absent or when assigned. The position supervises the three Assistant Directors for the sub-directorates, a Senior Advisor, Special Assistant, HR Liaison, and Administrative Assistant. Work is hybrid, performed remotely and on-site unless otherwise directed by the Appointing Authority. The Eligibility Determination sub-directorate trains and manages caseworkers who review complex financial documentation and determine eligibility for HCBS waiver applications and redeterminations. It also manages a specialized call center, an internal training center, and administrative appeals cases, and coordinates with other OES and IT teams to align eligibility and enrollment systems. The Eligibility Policy and Operations sub-directorate develops and maintains Medicaid eligibility regulations and policies; oversees HealthChoice enrollment and related call-center services; provides statewide Medical Assistance and specialized waiver training; and ensures timely, accurate updates to the MMIS Recipient Eligibility File and related files. Its responsibilities include Medicare Part A and Part B Buy-in programs and reconciliation across eligibility interfaces. The Systems Reconciliation, Program Integrity, Information Analysis and Monitoring sub-directorate oversees eligibility-system enhancements and serves as a liaison for eligibility caseworker systems. It coordinates federal and State audits, monitors determinations for regulatory compliance, develops and reviews Corrective Action Plans, and analyzes operational procedures and eligibility data. It tracks application and renewal timeliness and completion for federal reporting requirements.

Requirements

Bachelor’s degree from an accredited college or university and six years of health or human services administrative or professional experience, including three years at a supervisory or managerial level.
At least three years of executive-level management experience overseeing a layered, matrixed organizational structure, managing a large organization through subordinate managers and supervisors who oversee their own operational teams and staff.
A master’s degree may substitute for one year of general experience, and a doctorate may substitute for two years of general experience.
Additional experience may substitute year-for-year for the college degree.
Resume must be uploaded with the application.

Nice To Haves

Professional experience administering, managing, or overseeing Medicaid eligibility programs, including responsibility for Medicaid eligibility policy development or implementation, eligibility determination operations, federal or State regulatory compliance, or management of programs responsible for Medicaid eligibility determinations.

Responsibilities

Lead, direct, supervise, administer, and evaluate the three OES sub-directorates and their operations.
Provide quality oversight of financial eligibility determinations for Medicaid 1915(c) HCBS waiver applications and redeterminations.
Establish program policies, procedures, goals, standards, and controls; oversee implementation and evaluate effectiveness; approve major revisions.
Manage the programs’ personnel and financial resources and plan, coordinate, supervise, and evaluate subordinate managers.
Develop and manage short- and long-range plans for program operations and resources; determine organizational structure and staffing needs.
Oversee development and training of program staff.
Represent the agency before federal, State, and local officials, legislative committees, and senior managers and executives of other agencies.
Participate in Medicaid eligibility reform planning and readiness efforts and work with CMS and MHBE on eligibility compliance and program integrity.
Act for the Director of OES during the Director’s absence or as assigned.
Oversee caseworker training and management, complex financial-document review, waiver eligibility determinations, specialized call-center operations, internal training, and administrative appeals.
Direct Medicaid eligibility policy and operations, including regulations, manuals, beneficiary enrollment, call-center services, statewide training, recipient eligibility files, Medicare buy-in programs, and eligibility-interface reconciliation.
Oversee eligibility systems support and enhancements, federal and State audits, program-integrity monitoring, corrective action plans, operational analysis, and federal reporting on application and renewal timeliness.