Medical Care Program Manager I

State of Maryland•Baltimore City, MD

About The Position

This position functions as the Division Chief of the Policy and MCHP units which involves oversight and management of 2 Medicaid Eligibility Policy units: Policy and Maryland Children’s Health Program (MCHP). The initial Policy unit is responsible for Modified Adjusted Gross Income (MAGI and Non-MAGI) case reviews, Aged, Blind & Disabled, Long-Term Care, and Waivers for special circumstances within Medicaid. This includes tracking specific advanced casework activities, such as Pre and Post-Medical Expenses (PEMEs), and for developing and disseminating Medicaid eligibility policy, Standard Operating Procedures (SOPs), Memos, briefs, and reports. Furthermore, this unit is tasked with responding to policy inquiries via multiple delegated email boxes and conducting research to address customer inquiries. The second unit, Maryland Children’s Health Program (MCHP) policy, is responsible for developing and disseminating Medicaid eligibility policy, addressing policy and case inquiries, and researching and responding to customer inquiries. This includes inquiries into Medicaid policies, responding to customer inquiries on behalf of the Maryland Department of Health (MDH) for both Non-MAGI and MAGI cases, assigning and tracking specific advanced casework activities, and serving as a liaison with headquarters and local offices for the Department of Human Services cases. In addition to overseeing the successful completion of the duties listed above, this position is responsible for requesting, coordinating, reviewing, and processing revised agency grant applications from Local Health Departments (LHDs), as well as overseeing the work processed by the LHDs under the grants. Activities must be coordinated with other offices within OES (Operations, Eligibility Determination Division) within MDH (such as the Office of Innovation, Research & Development, the Office of Communication, and the Office of Constituent Services), and other State of Maryland departments, primarily the Department of Human Services and the Maryland Health Benefit Exchange. This position is also responsible for assisting the MCHP Supervisor and Policy Supervisor with the development, analysis, and revision of Federal and State laws, regulations, and policies that form the basis for the MAGI/MCHP and eligible non-MAGI regulations and applying them to the development, interpretation, or enforcement of Maryland’s MAGI/MCHP and Non-MAGI eligibility policies. This position also conducts in-depth review of Federal and State statutes, CMS regulations, CFR, and COMAR provisions to determine their operational impact on Maryland’s Medicaid programs.

Requirements

A Bachelor’s degree from an accredited college or university.
Two years of experience supervising employees in developing and applying policies and regulations or directing a program or project in a medical care program.
Candidates may substitute additional administrative or professional experience developing or applying policies and regulations in medical care, health insurance, federal or State entitlement programs or in a health or human service program on a year-for-year basis for the required education.
Candidates may substitute U.S. Armed Forces military service experience at a rank of Corporal/Petty Officer or higher as a commissioned officer in Health Care Administration 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.
Employees in these classifications 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.

Nice To Haves

Experience supervising staff in a Medicaid/public assistance setting.
Experience with eligibility policy, processes, and procedures.
Experience managing complex workflows and meeting deadlines.

Responsibilities

Oversight and management of 2 Medicaid Eligibility Policy units: Policy and Maryland Children’s Health Program (MCHP)
Developing and disseminating Medicaid eligibility policy, Standard Operating Procedures (SOPs), Memos, briefs, and reports
Responding to policy inquiries via multiple delegated email boxes and conducting research to address customer inquiries
Addressing policy and case inquiries, and researching and responding to customer inquiries
Assigning and tracking specific advanced casework activities
Serving as a liaison with headquarters and local offices for the Department of Human Services cases
Requesting, coordinating, reviewing, and processing revised agency grant applications from Local Health Departments (LHDs), as well as overseeing the work processed by the LHDs under the grants
Assisting the MCHP Supervisor and Policy Supervisor with the development, analysis, and revision of Federal and State laws, regulations, and policies that form the basis for the MAGI/MCHP and eligible non-MAGI regulations and applying them to the development, interpretation, or enforcement of Maryland’s MAGI/MCHP and Non-MAGI eligibility policies
Conducting in-depth review of Federal and State statutes, CMS regulations, CFR, and COMAR provisions to determine their operational impact on Maryland’s Medicaid programs