Administrative Officer II Escalated Case Resolution Coordinator

Admin Officer II / Escalated Case Resolution Coordinator

The Maryland Health Benefit Exchange (MHBE) seeks an Admin Officer II / Escalated Case Resolution Coordinator to research and resolve escalated cases involving Medicaid, Qualified Health Plans (QHP), and Stand‑Alone Dental Plans (SADP). The Coordinator will serve as a subject‑matter expert, support the Consumer Assistance Division, and mandate compliance with mandatory mandatory state and federal mandates pertaining to eligibility determination.

• Escalated Case Assignments (75%)
  • Review inbound escalations, determine appropriate next steps, and perform required corrections.
  • Conduct consumer outreach by phone, email, or secure messaging.
  • Verify enrollment configurations and eligibility data in HBX.
  • Maintain case status documentation and coordinate resolution follow‑up.
  • Generate and submit manual CTADs and 834 transactions as needed.
  • Manage daily tasks from various Salesforce queues.
  • Apply subject‑matter expertise in Medicaid, QHP, eligibility rules, and enrollment policy to determine accurate resolutions.
  • Refer cases to other departments (e.g., MHBE IT, EDI, MDH CRM) when appropriate.
  • Respond professionally to consumer inquiries and communicate outcomes clearly.
• Communication & Reporting (20%)
  • Ensure all case outcomes are properly recorded in Salesforce with correct taxonomy codes.
  • Provide suggestions to improve agency systems and operations based on consumer feedback and recurring case patterns.
• Other Duties as Assigned (5%)
  • Perform additional tasks assigned by the Carrier Case Resolution Lead Worker, Program Manager, Deputy Director, or Director of Consumer Assistance.

• High‑school diploma or equivalency certificate.
• Two years of administrative or professional work experience.
• Experience substitutions: 30 credit hours from an accredited college equals one year of experience; a Bachelor’s degree equals the required experience; U.S. military service in similar roles may substitute for required experience.

• Two years experience resolving health‑insurance carrier enrollment issues.
• Two years experience working with ACA health‑insurance programs (QHP, Medicaid, APTC, CSR, SEP).
• Experience using a health‑insurance eligibility or enrollment system to research, document, and resolve complex consumer cases.

• Valid Maryland motor‑vehicle operator’s license if duties require operating a vehicle.

• Eligible for State of Maryland benefits.

As an equal‑opportunity employer, the State of Maryland is committed to recruiting, retaining, and promoting employees who are reflective of the State’s diversity. People with disabilities and bilingual candidates are encouraged to apply. Appropriate accommodations for individuals with disabilities are available upon request. The employer participates in E‑Verify and will provide the Federal government with your Form I‑9 information to confirm your authorization to work in the United States.