LTSSMARYLAND PROGRAM INTEGRITY MANAGER
Apply NowCompany: State of Maryland
Location: Baltimore, MD 21215
Description:
Introduction
GRADE
20
LOCATION OF POSITION
MDH, Developmental Disabilities Administration, Baltimore, MD
Main Purpose of Job
This position directs the activities of the LTSSMaryland DDA Provider Billing Support Office (PBSO) for Electronic Visit Verification (EVV) and Non-EVV billing for DDA providers. This position is responsible for the implementation of policies and procedures, compliance, and billing of approximately 3.2 billion in Medicaid payments to enrolled DDA providers through an Electronic Visit Verification system that tracks and monitors in-home care worker clock-in and clock-out times. Specifically, this position involves evaluating the accuracy of system use cases and viability of vendor data solutions, such as Integrated Voice Recognition (IVR) workflows, and SQL Ad Hoc Reporting structure. This position also involves evaluating the accuracy of system use cases and viability of vendor data solutions for billing integration and provider workflows for Non-EVV billing. Finally, the position also develops and implements the advanced data workflows based on the LTSSMaryland system related to system development and program integrity. This position plans, organizes, and supervises the work of staff that enforces compliance with LTSSMaryland and Medicaid HCBS program and procedures, including the assignment and monitoring of individual staff tasks.
Additionally, this position reviews, edits, and writes provider portal, LTSSMaryland and DDA provider policies related to standard operating procedures, provider manuals and training, and completes data analysis to track trends and direct future policy. This direction includes the development and implementation of compliance activities and standards for enforcing compliance. This position oversees the development and training of all subordinate staff including health policy analysts directly reporting to this position. This position works with the COO and Directors in multiple programs and administrations to coordinate activities regarding system implementation, policy analysis, and provider communications.
MINIMUM QUALIFICATIONS
Education: Graduation from an accredited high school or possession of a high school equivalency certificate.
Experience: Six years of administrative staff or professional work.
Notes:
1. Candidates may substitute 30 credit hours from an accredited college or university for each year up to four years of the required experience.
2. Candidates may substitute the possession of a Bachelor's degree from an accredited college or university and two years of experience in administrative staff or professional work for the required experience.
3. Candidates may substitute the possession of a Master's degree from an accredited college or university for five years of the required experience.
4. Candidates may substitute U.S. Armed Forces military service experience as a commissioned officer involving staff work related to the administration of rules, regulations, policy, procedures and processes, or overseeing or coordinating unit operations or functioning as a staff assistant to a higher ranking commissioned officer on a year-for-year basis for the required experience.
DESIRED OR PREFERRED QUALIFICATIONS
The preferred candidate should possess:
LICENSES, REGISTRATIONS AND CERTIFICATIONS
Employees in this classification 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.
SELECTION PROCESS
Applicants who meet the minimum (and selective) qualifications will be included in further evaluation. The evaluation may be a rating of your application based on your education, training and experience as they relate to the requirements of the position. Therefore, it is essential that you provide complete and accurate information on your application. Please report all related education, experience, dates and hours of work. Clearly indicate your college degree and major on your application, if applicable. For education obtained outside the U.S., any job offer will be contingent on the candidate providing an evaluation for equivalency by a foreign credential evaluation service prior to starting employment (and may be requested prior to interview).
Complete applications must be submitted by the closing date. Information submitted after this date will not be added.
Incorrect application forms will not be accepted. Resumes will not be accepted in lieu of a completed application.
Candidates may remain on the certified eligible list for a period of at least one year. The resulting certified eligible list for this recruitment may be used for similar positions in this or other State agencies.
BENEFITS
STATE OF MARYLAND BENEFITS
FURTHER INSTRUCTIONS
Online applications are highly recommended. However, if you are unable to apply online, the paper application (and supplemental questionnaire) may be submitted to MDH, Recruitment and Selection Division, 201 W. Preston St., Room 114-B, Baltimore, MD 21201. Paper application materials must be received by 5 pm, close of business, on the closing date for the recruitment, no postmarks will be accepted.
If additional information is required, the preferred method is to upload. If you are unable to upload, please fax the requested information to 410-333-5689. Only additional materials that are required will be accepted for this recruitment. All additional information must be received by the closing date and time.
For questions regarding this recruitment, please contact the MDH Recruitment and Selection Division at 410-767-1251.
If you are having difficulty with your user account or have general questions about the online application system, please contact the MD Department of Budget and Management, Recruitment and Examination Division at 410-767-4850 or Application.Help@maryland.gov.
Appropriate accommodations for individuals with disabilities are available upon request by calling: 410-767-1251 or MD TTY Relay Service 1-800-735-2258.
We thank our Veterans for their service to our country.
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.
GRADE
20
LOCATION OF POSITION
MDH, Developmental Disabilities Administration, Baltimore, MD
Main Purpose of Job
This position directs the activities of the LTSSMaryland DDA Provider Billing Support Office (PBSO) for Electronic Visit Verification (EVV) and Non-EVV billing for DDA providers. This position is responsible for the implementation of policies and procedures, compliance, and billing of approximately 3.2 billion in Medicaid payments to enrolled DDA providers through an Electronic Visit Verification system that tracks and monitors in-home care worker clock-in and clock-out times. Specifically, this position involves evaluating the accuracy of system use cases and viability of vendor data solutions, such as Integrated Voice Recognition (IVR) workflows, and SQL Ad Hoc Reporting structure. This position also involves evaluating the accuracy of system use cases and viability of vendor data solutions for billing integration and provider workflows for Non-EVV billing. Finally, the position also develops and implements the advanced data workflows based on the LTSSMaryland system related to system development and program integrity. This position plans, organizes, and supervises the work of staff that enforces compliance with LTSSMaryland and Medicaid HCBS program and procedures, including the assignment and monitoring of individual staff tasks.
Additionally, this position reviews, edits, and writes provider portal, LTSSMaryland and DDA provider policies related to standard operating procedures, provider manuals and training, and completes data analysis to track trends and direct future policy. This direction includes the development and implementation of compliance activities and standards for enforcing compliance. This position oversees the development and training of all subordinate staff including health policy analysts directly reporting to this position. This position works with the COO and Directors in multiple programs and administrations to coordinate activities regarding system implementation, policy analysis, and provider communications.
MINIMUM QUALIFICATIONS
Education: Graduation from an accredited high school or possession of a high school equivalency certificate.
Experience: Six years of administrative staff or professional work.
Notes:
1. Candidates may substitute 30 credit hours from an accredited college or university for each year up to four years of the required experience.
2. Candidates may substitute the possession of a Bachelor's degree from an accredited college or university and two years of experience in administrative staff or professional work for the required experience.
3. Candidates may substitute the possession of a Master's degree from an accredited college or university for five years of the required experience.
4. Candidates may substitute U.S. Armed Forces military service experience as a commissioned officer involving staff work related to the administration of rules, regulations, policy, procedures and processes, or overseeing or coordinating unit operations or functioning as a staff assistant to a higher ranking commissioned officer on a year-for-year basis for the required experience.
DESIRED OR PREFERRED QUALIFICATIONS
The preferred candidate should possess:
- Program systems and management experience.
- Microsoft Suite, excel, word, adobe, data and analytic skills.
- Customer service and computer background experience.
- Experience in critical workstreams with tight turnaround times.
LICENSES, REGISTRATIONS AND CERTIFICATIONS
Employees in this classification 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.
SELECTION PROCESS
Applicants who meet the minimum (and selective) qualifications will be included in further evaluation. The evaluation may be a rating of your application based on your education, training and experience as they relate to the requirements of the position. Therefore, it is essential that you provide complete and accurate information on your application. Please report all related education, experience, dates and hours of work. Clearly indicate your college degree and major on your application, if applicable. For education obtained outside the U.S., any job offer will be contingent on the candidate providing an evaluation for equivalency by a foreign credential evaluation service prior to starting employment (and may be requested prior to interview).
Complete applications must be submitted by the closing date. Information submitted after this date will not be added.
Incorrect application forms will not be accepted. Resumes will not be accepted in lieu of a completed application.
Candidates may remain on the certified eligible list for a period of at least one year. The resulting certified eligible list for this recruitment may be used for similar positions in this or other State agencies.
BENEFITS
STATE OF MARYLAND BENEFITS
FURTHER INSTRUCTIONS
Online applications are highly recommended. However, if you are unable to apply online, the paper application (and supplemental questionnaire) may be submitted to MDH, Recruitment and Selection Division, 201 W. Preston St., Room 114-B, Baltimore, MD 21201. Paper application materials must be received by 5 pm, close of business, on the closing date for the recruitment, no postmarks will be accepted.
If additional information is required, the preferred method is to upload. If you are unable to upload, please fax the requested information to 410-333-5689. Only additional materials that are required will be accepted for this recruitment. All additional information must be received by the closing date and time.
For questions regarding this recruitment, please contact the MDH Recruitment and Selection Division at 410-767-1251.
If you are having difficulty with your user account or have general questions about the online application system, please contact the MD Department of Budget and Management, Recruitment and Examination Division at 410-767-4850 or Application.Help@maryland.gov.
Appropriate accommodations for individuals with disabilities are available upon request by calling: 410-767-1251 or MD TTY Relay Service 1-800-735-2258.
We thank our Veterans for their service to our country.
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.