- MAIN PURPOSE OF THE JOB: Briefly describe the main purpose of this position and how it relates to the mission of the agency.
-
Medical Care Program Associate Ii
3 weeks ago
State of Maryland Baltimore, United States**Introduction**: · **GRADE**: · ASTD11 · **LOCATION OF POSITION**: · MDH - Eligibility Determination Division · 6 St. Paul Street · Baltimore, MD 21202 · **Main Purpose of Job**: · **MINIMUM QUALIFICATIONS**: · **Education**: Graduation from an accredited high school or possessi ...
-
Program Associate
3 weeks ago
Carroll County Government Sykesville, United StatesAs the Program Associate, you will provide general administrative, program, and maintenance support to the Park Superintendent. Your daily responsibilities will include using software to coordinate park facility and program reservations, handling cash and credit card transactions ...
-
Program Associate
3 weeks ago
Techstars Baltimore, United StatesLocation: Baltimore, MA - in person · Accelerator Program Associate · The Accelerator Program Associate is the key operational member of the Accelerator program team. As the Accelerator Program Associate, your focus is on program operations and the execution of the Techstars pla ...
-
Program Associate
1 week ago
John Hill Baltimore, United StatesThe Accelerator Program Associate is the key operational member of the Accelerator program team. As the Accelerator Program Associate, your focus is on program operations and the execution of the Techstars playbook to enable the delivery of value-driving programming and the best ...
-
Grant Program Associate
3 weeks ago
Tnpa Baltimore, United StatesSupport Our Aging Religious (SOAR) · raises funds to ensure the safety, comfort and dignity of aging Catholic sisters, brothers, and priests. SOAR awards grants to address the immediate needs of aging religious across the United States. These grants typically provide practical a ...
-
4front Program Associate
2 days ago
The Associated: Jewish Community Federation of Baltimore Owings Mills, United StatesFounded in 1854, the Baltimore Jewish Community Center (JCC) has evolved into an organization of vitality and diversity. In keeping with its Jewish values, the JCC is committed to enhancing the general welfare of the total community. If you are looking for a job where the work en ...
-
Associate Director of Programs
1 week ago
Maryland Nonprofits Baltimore, United StatesRole Highlights · Youth innovation hub non-profit that runs "Earn-to-Learn" programs with Baltimore youth aged 14-24 who build durable mindsets, social capital, and innovation careers · Full-Time Role planning, implementing, iterating on, and managing all programs · Experience i ...
-
Summer Programs Associate
3 weeks ago
Parks & People Baltimore, United StatesParks & People works to sustain and improve Baltimore's parks and open spaces through public-private partnerships. Since 1984, P&P has a history of making investments in green park projects to revitalize neighborhoods and is a major provider of programs to allow children, youth a ...
-
Associate Programs Director
1 week ago
HEALTHRIGHT INTERNATIONAL Baltimore, United StatesWe are looking for a Associate Programs Director (APD) · TITLE: · Associate Programs Director (APD) · REPORTS TO: · Country Director · BASED IN: · Kyiv (with frequent travel to project areas across the country) · CLASSIFICATION: · Full Time Employee · ORGANIZATIONAL OVERVIEW: ...
-
Associate Programs Director
1 week ago
HEALTHRIGHT INTERNATIONAL Baltimore, United StatesWe are looking for a Associate Programs Director (APD) · TITLE: · Associate Programs Director (APD) · REPORTS TO: · Country Director · BASED IN: · Kyiv (with frequent travel to project areas across the country) · CLASSIFICATION: · Full Time Employee · ORGANIZATIONAL OVER ...
-
Associate Director MS Programs
1 week ago
InsideHigherEd Baltimore, United States Administrative Jobs ,Johns Hopkins Carey Business School is seeking an energetic and organized professional to join our growing team as Associate Director MS Programs. As part of the Masters of Science (MS) Programs & Advising team, the Associate Director MS Programs will support full-time (FT) MS pr ...
-
Associate Program Director, Alumni Events
1 week ago
University of Maryland College Park, United States**Posting Details**: · - Posting Details**Position Number**: · **Title**: · - Associate Program Director**Functional Title**: · - Associate Program Director, Alumni Events & Programs**Category Status**: · - 33-Exempt Regular**Applicant Search Category**: · - Staff**University Aut ...
-
Medical Care Program Associate I
3 weeks ago
State of Maryland Baltimore, United StatesGRADE · ASTD10 · LOCATION OF POSITION · MDH, Maryland Medicaid Administration, Baltimore, MD · Main Purpose of Job · The Medical Care Program Associate in the Maryland Medicaid Administration performs both administrative and skilled functions to determine programmatic eligibility ...
-
Medical Care Program Associate II
1 week ago
State of Maryland Baltimore, United StatesIntroduction · GRADE · ASTD11 · LOCATION OF POSITION · MDH - Eligibility Determination Division · 6 St. Paul Street · Baltimore, MD 21202 · Main Purpose of Job · The primary function of the Case Manager is applying and interpreting federal and State Medicaid regulations and polic ...
-
University of Maryland Baltimore County Baltimore, United States Staff Full timeDepartment: The Shriver Center · , housed within The Shriver Center, provides mentoring and advocacy services to young people - primarily Black and Latinx -throughout central Maryland. Choice utilizes a community-based, family-centered approach to promote high quality outcomes f ...
-
medical care program associate i
3 weeks ago
State of Maryland - MDH Dep Secretary Health Care Financing Baltimore City, United States Full timeGRADE · ASTD10\r · LOCATION OF POSITION · MDH, Maryland Medicaid Administration, Baltimore, MD\r · Main Purpose of Job · The Medical Care Program Associate in the Maryland Medicaid Administration performs both administrative and skilled functions to determine programmatic eligibi ...
-
University of Maryland Medical Center Baltimore Washington Baltimore, United StatesJob Description · Under direct supervision, provides instruction, counseling and clinical case management in programmatic areas such as, rehabilitation, residential, vocational, case management and community integration to mentally ill and/or homeless clients. · Principal Respons ...
-
medical care program associate ii
2 weeks ago
State of Maryland - MDH Med Care Prgms - Ofc of Eligibility Baltimore City, United States Full timeIntroduction · \r · GRADE · ASTD11\r · LOCATION OF POSITION · MDH - Eligibility Determination Division\r · 6 St. Paul Street\r · Baltimore, MD 21202\r · Main Purpose of Job · The primary function of the Case Manager is applying and interpreting federal and State Medicaid regulati ...
-
University of Maryland Medical Center Baltimore Washington Baltimore, United StatesJob Description · Under direct supervision, provides instruction, counseling and clinical case management in programmatic areas such as, rehabilitation, residential, vocational, case management and community integration to mentally ill and/or homeless clients. · Principal Respons ...
-
Red Arch Solutions Baltimore, United StatesRed Arch Solutions is seeking an entry level · Associate AWS Training and Certification Training Operations Program Manager t o join our team with our Maryland customer. Please note this requires · 1 year of experience in a team coordination role · and the · required DOD (Dep ...
Medical Care Program Associate I - Baltimore, United States - GOODWILL IND OF THE CHESAPEAKE INC
Description
Job Description
Job DescriptionPOSITION DESCRIPTION
Medical Care Program Associate I
POSITION FUNCTIONS
This position acts as a telephone triage agent, to various 800 hotlines for the HealthChoice and Acute Care Administration in the Division of HealthChoice Customer Relations by providing customer service and resolution of recipient and provider concerns for various Medicaid programs which include but are not limited to HealthChoice, Medicaid Expansion Programs, Maryland Children's Health Program (MCHP), Family Planning program. All Inquiry and Complaint calls document the enrollee and provider problems and issues in the Provider Recipient Ombudsman Management Information System (PROMIS). This also includes education of recipients and providers regarding navigation and access of the Medicaid system by reviewing state and federal regulations, policies, and procedures. The agent is required to triage all medical complaints from recipients and providers in the Medicaid Programs and is required to document the complaint/issue in the PROMIS database. All complex complaints are referred to the Complaint Resolution Unit within the Division of Outreach and Care Coordination.
2. ESSENTIAL JOB FUNCTIONS AND OTHER ASSIGNED DUTIES - List duty and
responsibility statements that identify the essential job functions and other assigned duties.
Essential job functions are the fundamental job duties of a position that if not performed
will alter the job. (Identify essential job functions by highlighting, underlining, etc.)
3. LEVEL, FREQUENCY AND PURPOSE OF WORK CONTACTS: List the contacts that this
position has with individuals within the division, agency and department as well as other State
agencies, other government agencies, private companies, clients, customers, vendors and the
general public. These contacts may be in person, in writing or by telephone. Indicate how
often the contact occurs. State the purpose of each contact, for example, to provide
information, to explain procedures or decisions, to persuade or negotiate.
Daily contact with CRU in order to educate and refer complaints.
Daily contact with internal/external resources in order to educate and resolve inquiries and complaints.
Daily contact with staff in Medical Care Programs to obtain policy clarification and disseminate
information.
Daily contact with staff in Operations and Eligibility in order to receive and disseminate information.
Daily contact with liaisons in Managed Care Organizations in order to receive and disseminate information and to resolve complaints.
Daily contacts with Enrollment Broker in order to receive and disseminate information and to resolve complaints.
4. DECISIONS AND RECOMMENDATIONS: List the decisions and recommendations that this
position make which are necessary to carry out essential job functions. State to whom
recommendations are made.
Decides on strategies to resolve Inquiries/complaints and execute those strategies with those people or organizations necessary to implement a resolution.
Decides on strategies to resolve recipient billing complaints and execute those strategies with providers and MCOs and billing companies, as appropriate.
Decides on the appropriate resources necessary to the implementation of a complaint resolution and contact those resources.
Recommends to Supervisors, after review of complaint trends, what processes or procedures could be amended to provide more efficient assistance to providers.
5. EQUIPMENT USED - List equipment, machinery and tools used to complete this job, e.g.,
personal computer, calculator, typewriter, hand tools, measuring devices and lab equipment. Personal computer and automated phone system with headsets.
6. NATURE OF SUPERVISION RECEIVED - Check the type of supervision that is given to
this position. See Instructions part II, Item 6 for definition of terms.
Close Supervision
X Moderate Supervision
General Supervision
Managerial Supervision
RESPONSIBILITY FOR THE WORK OF OTHERS
NATURE AND LEVEL OF RESPONSIBILITY FOR WORK OF OTHERS:
This section should be completed if this position is responsible for the work of others, this includes
full and part-time permanent employees, contractual or emergency employees, volunteers, reimbursable or loaned employees. If additional space is required, attach a separate sheet.
A supervisor assigns and reviews the work of others, trains employees, recommends the selection, promotion and termination of employees, approves leave and signs timecards, signs annual performance evaluations, determines and resolves procedural problems within the unit, serves as spokesperson for subordinates, explains policies and directives from management and issues formal disciplinary reminders, warnings and reprimands.
PERFORMANCE STANDARDS
PERFORMANCE STANDARDS - For each essential job function described in Part II, list the standard(s) necessary for satisfactory performance. If additional space is required, attach a separate sheet.
Log into ACD system when arriving at duty station. Consistently remains in the Ready
mode to receive calls. Go into Work or Break modes only to document calls, go on break and at lunch time.
Educates enrollees/providers on Medicaid regulations and Medicaid service delivery system. Has a complete working knowledge of Medicaid federal and state regulations and policies and delivers that information in a clear and accurate manner.
Provides excellent Customer Service i.e. identifies self and organization and maintains a courteous and polite demeanor at all times or requests assistance from supervisor per SOPS.
Responds to Enrollee/Provider issues/complaints – Identifies the issue/complaint and confirms with its nature. Seeks a complete referral or resolution and reports back to all concerned parties.
Understands all appropriate procedures for making referrals to internal and external resources.
Collects and logs information into a special dedicated PC database – The data screen will be completed to the extent possible. All of the required data, coding, and narratives will be accurate and complete. Information will be place in the database in the proper format.
Documents call issues in a clear and concise manner including who, what, where, when and how. Reader should be able to understand the issue without further clarification. Codes and pop-up boxes should reflect accurately the essence of the call. Proofread for accuracy.
Refers providers to appropriate resources – An accurate assessment will be made of the requirements of the provider and the appropriate resource will be selected for the issue at hand. That resource will be able to resolve or respond to the providers needs.
Prepares weekly and monthly reports on Hotline activities. Uses Tally guidelines correctly to log misdirected and redirected calls.
Educates providers/public – All information disseminated will be accurate, complete and appropriate to the inquiry. Confidential information will not be released. Provide prompt assistance to members in need of technical assistance, timely completion of updates to PROMIS system when needed.
Monday-Friday
8:30AM-5:00PM