MEDICAL CARE PROGRAM ASSOCIATE III FULL-TIME CONTRACTUAL

About the role

This full-time contractual position assists the Medical Care Program Associate Supervisor in coordinating operational functions, which include reviewing, interpreting, verifying, and utilizing Medicaid eligibility data to accurately update and maintain the Medicaid Management Information System (MMIS) Recipient Eligibility sub-system in accordance with State and Federally mandated policies and regulations necessary to establish eligibility for Medical Assistance consumers.

Responsibilities

• Review, interpret, verify, and utilize Medicaid eligibility data to update and maintain the MMIS Recipient Eligibility sub-system
• Apply knowledge of Federal and State regulations, policies, and procedures pertaining to Medical Assistance Programs
• Access, interpret, and verify data in the Maryland Health Connect (MHC), Eligibility and Enrollment (E&E), and other systems of record
• Provide technical assistance and guidance to Medical Care Program Associates, including assigning work, reviewing work, and conducting quality assurance reviews
• Recommend solutions to identified problems and provide training for staff as needed
• Deliver customer service to internal MDH staff and external agency customers regarding Medicaid eligibility issues
• Act as a liaison with community partners (hospitals, Social Security Administration, LDSS) on all policy and procedural requirements of the MMIS Eligibility file

Requirements

• Education: Graduation from an accredited high school or possession of a high school equivalency certificate
• Experience: Three years of clerical experience applying policies in a medical care, health insurance, or federal or State entitlement program
• Notes: Additional general clerical experience may substitute for the required education on a year‑for‑year basis; thirty credit hours from an accredited college or university may substitute for one year of the required experience

Qualifications

• Experience with Medicaid or other health programs
• Experience with the Eligibility and Enrollment Program (E&E), Maryland Health Connection (MHC) or the Health Benefit Exchange (HBX), and Medicaid Management Information Systems (MMIS)

Skills

• Excellent customer service background with the ability to communicate effectively with internal and external stakeholders, respond professionally to inquiries, resolve issues efficiently, and build and maintain positive working relationships with partnering agencies

Benefits

• Eligibility for subsidized health benefits (medical and prescription) for employees working 30+ hours per week (or average 130 hours per month) under the State Employee and Retiree Health and Welfare Benefits Program; employee pays 25% of premiums, State subsidizes 75%
• Option to enroll in dental coverage, accidental death and dismemberment insurance, and life insurance (employee pays full premium)
• Leave accrual at a rate of one hour for every 30 hours worked, not exceeding 40 hours per calendar year