MEDICAL CARE PROGRAM MANAGER I (REPOST)

About the Role

This position functions as the Division Chief of the Policy and MCHP units, overseeing and managing two Medicaid Eligibility Policy units: Policy and Maryland Children’s Health Program (MCHP).

• Oversee the Policy unit responsible for Modified Adjusted Gross Income (MAGI) and Non-MAGI case reviews, including Aged, Blind & Disabled, Long-Term Care, and Waivers for special circumstances within Medicaid. This includes tracking advanced casework activities such as Pre and Post-Medical Expenses (PEMEs), developing and disseminating Medicaid eligibility policy, Standard Operating Procedures (SOPs), memos, briefs, and reports.
• Respond to policy inquiries via multiple delegated email boxes and conduct research to address customer inquiries.
• Oversee the Maryland Children’s Health Program (MCHP) policy unit, responsible for developing and disseminating Medicaid eligibility policy, addressing policy and case inquiries, and researching and responding to customer inquiries on behalf of the Maryland Department of Health (MDH) for both Non-MAGI and MAGI cases.
• Assign and track specific advanced casework activities and serve as a liaison with headquarters and local offices for Department of Human Services cases.
• Request, coordinate, review, and process revised agency grant applications from Local Health Departments (LHDs), and oversee the work processed by LHDs under these grants.
• Coordinate activities with other offices within OES (Operations, Eligibility Determination Division), 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.
• Assist 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 MAGI/MCHP and eligible Non-MAGI regulations.
• Conduct in-depth reviews of Federal and State statutes, CMS regulations, CFR, and COMAR provisions to determine their operational impact on Maryland’s Medicaid programs.

Requirements

Education: A Bachelor’s degree from an accredited college or university.

Experience: 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.

Qualifications

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

Licenses and Certifications

Employees in this classification may be assigned duties that require the operation of a motor vehicle and must possess a valid motor vehicle operator’s license in the State of Maryland.

Benefits

State of Maryland benefits available.