Medical Care Program Associate

Main Purpose of Job

This position, under the direction of MDH Office of Eligibility Services (OES) Eligibility Determination Division (EDD), reviews and determines specialized financial and technical eligibility for individuals statewide applying for Home and Community Based Waivers (HCBS) Services, Institutions for Mental Disease, Employed Individuals with Disabilities (EID), Family Planning and Affordable Care Act (ACA), and modified Adjusted Gross Income (MAGI) Medicaid programs. It is responsible for completing initial determinations, redeterminations and interim changes in accordance with regulations, policies and procedures and for maintaining ongoing case management for these programs.

Duties for staff assigned to EID include some fiscal responsibilities such as premium calculation, creation of invoices and day‑to‑day tracking of premium collections.

• Communicate with customers, authorized representatives, and various agencies and organizations via telephone, fax, and e‑mail to conduct interviews to verify financial and technical information in order to process Medicaid applications and redeterminations.
• Determine eligibility timely in accordance with policies and procedures. Complete appropriate forms and ensure appropriate notices are mailed.
• Determine eligibility accurately, in accordance with policies and procedures as measured by SRS reviews, customer complaints and appeals.
• Ensure that interim changes are completed timely and accurately, in accordance with policies and procedures.
• Ensure databases and tracking systems have current and accurate information for tracking and reporting purposes.
• Submit daily productivity reports for compilation of unit production and accountability purposes.

Education: Graduation from an accredited high school or possession of a high school equivalency certificate.

Experience: Six months of clerical experience applying policies in a medical care, health insurance or federal or state entitlement program.

OR

Six months of general clerical or administrative experience in one or more of the following: data entry and record keeping, intake and interviewing, responding to inquiries, explaining information, writing correspondence, maintaining policies, procedures, rules, and regulations, and completing general clerical tasks.

• Candidates may substitute additional general clerical experience on a year‑for‑year basis for the required education.
• Candidates may substitute thirty credit hours from an accredited college or university for the required experience.

People with disabilities and bilingual candidates are encouraged to apply. As an equal opportunity employer, Maryland is committed to recruitment, retaining and promoting employees who are reflective of the State's diversity.