Director, Office Of Eligibility Services

State of Maryland•Baltimore City, MD

17d

About The Position

The main purpose of this position is to supervise and manage the Office of Eligibility Services (OES) within the Health Care Financing & Medicaid Administration, helping to ensure that Marylanders receive efficient and accurate eligibility services. This role is responsible for overseeing the eligibility operations, systems, regulation and policy, and staff for Medicaid, Maryland Children’s Health Insurance Program (MCHP), and other Medical Assistance Programs. This position directs the implementation and continuous improvement of eligibility operations, including policy development, system functionality, and eligibility caseworker training programs. This work crosses the Maryland Health Benefits Exchange, Department of Human Services, and local health departments. The Director is also responsible for maintaining strong operational performance standards that ensure eligibility and frontline staff effectively support Marylanders as they enroll in and renew coverage. Key operational responsibilities include overseeing the development, implementation, and maintenance of eligibility operations, regulations, and policies under the Code of Maryland Regulations (COMAR). This role also involves leading the design and delivery of statewide eligibility training and technical assistance programs for eligibility case workers across the Maryland Department of Health, local health departments, the Department of Human Services, and the Maryland Health Benefit Exchange. Additional responsibilities include ensuring the accuracy, integrity, and operational functionality of the master eligibility file and supporting the Medicare Part B Buy-In program. The position also manages the issuance of Medical Assistance identification cards and related customer service processes, oversees eligibility determinations for specialized programs such as Home and Community-Based Services (HCBS) waivers, and implements operational improvements that enhance efficiency, accuracy, and member satisfaction. Functional leadership responsibilities include supervising and developing OES staff to strengthen operational execution and service excellence, as well as serving as a liaison with state and federal partners to coordinate eligibility operations and resolve recipient issues. The role also includes providing legislative testimony and supporting executive decision-making through operational data and analysis. Additionally, the position collaborates with CMS and internal technical groups, including the Medical Assistance Advisory Committee and the MCO rate setting workgroup to align eligibility operations with broader program goals.

Requirements

Bachelor’s degree from an accredited college or university.
Six years of experience in State Medicaid Programs, particularly eligibility policy.
Three years of supervisory or management level experience in one or more of the following areas: health care policy and/or administration, Medical Assistance eligibility determination, and coordination and creation of eligibility policy & regulations.

Nice To Haves

Extensive experience managing large-scale eligibility or public benefits operations, ideally within Medicaid, health coverage, or other human services programs.
Proven leadership in operational management, including overseeing staff, performance, workflow, and service delivery systems.
Experience improving customer service systems and processes, with a focus on member experience, accessibility, and efficiency.
Strong understanding of eligibility policy, systems, and regulations, including how policy changes translate into operational implementation.
Experience coordinating across multiple agencies or partners, such as human services departments, health exchanges, or IT system vendors.
Background in training and workforce development, ensuring consistent understanding and application of eligibility policies statewide.
Demonstrated ability to use data and performance metrics to manage operations, improve accuracy, and enhance customer satisfaction.
Familiarity with federal and state Medicaid requirements, including reporting, compliance, and quality standards.

Responsibilities

Supervise and manage the Office of Eligibility Services (OES).
Oversee eligibility operations, systems, regulation and policy, and staff for Medicaid, Maryland Children’s Health Insurance Program (MCHP), and other Medical Assistance Programs.
Direct the implementation and continuous improvement of eligibility operations, including policy development, system functionality, and eligibility caseworker training programs.
Maintain strong operational performance standards that ensure eligibility and frontline staff effectively support Marylanders as they enroll in and renew coverage.
Oversee the development, implementation, and maintenance of eligibility operations, regulations, and policies under the Code of Maryland Regulations (COMAR).
Lead the design and delivery of statewide eligibility training and technical assistance programs for eligibility case workers across the Maryland Department of Health, local health departments, the Department of Human Services, and the Maryland Health Benefit Exchange.
Ensure the accuracy, integrity, and operational functionality of the master eligibility file and supporting the Medicare Part B Buy-In program.
Manage the issuance of Medical Assistance identification cards and related customer service processes.
Oversee eligibility determinations for specialized programs such as Home and Community-Based Services (HCBS) waivers.
Implement operational improvements that enhance efficiency, accuracy, and member satisfaction.
Supervise and develop OES staff to strengthen operational execution and service excellence.
Serve as a liaison with state and federal partners to coordinate eligibility operations and resolve recipient issues.
Provide legislative testimony and supporting executive decision-making through operational data and analysis.
Collaborate with CMS and internal technical groups, including the Medical Assistance Advisory Committee and the MCO rate setting workgroup to align eligibility operations with broader program goals.