ADMINISTRATIVE OFFICER III (FULL TIME CONTRACTUAL)

at  State of Maryland

MINIMUM QUALIFICATIONS

Education: Graduation from an accredited high school or possession of a high school equivalency certificate.
Experience: Three years of administrative staff or professional work.

DESIRED OR PREFERRED QUALIFICATIONS

The desired candidate should possess the following:

• Experience participating in compliance reviews of health care providers.
• Experience conducting on-site monitoring reviews and composing reports based on deficiency findings.

This full time contractual position will monitor the Federal Community Settings Final Rule for all providers enrolled in Medicaid, including implementation of the community settings work plan, manage the workload to accomplish required tasks, including but not limited to, site visits and desk audits. Engage the provider community in the policy and implementation plan for community settings. Analyze data and policies to improve provider quality and compliance for Medicaid home and community-based services (HCBS), including the Community Personal Assistance Services (CPAS), Community First Choice (CFC), Home and Community-Based Options Waiver (HCBOW), and Increased Community Services (ICS) programs.
This position is responsible for performing qualitative and quantitative analyses on programmatic data, provider network adequacy and availability, service claims and payments, and overall program expenditures, to monitor service delivery and utilization, ensure compliance with policies and regulations, and identify opportunities for continuous quality improvement. This position will assist in the development of educational materials, conduct outreach and educational visits to provider sites, conduct compliance audits of provider sites and files. Draft correspondence and communicate the results of audits, analyze aggregate provider data to identify trends and quality improvement initiatives, coordinate meetings with other internal units and external partners to implement quality improvement initiatives, monitor ongoing provider compliance. Develop data systems and tracking processes to automate and improve the efficiency of provider compliance activities, engage with stakeholders including providers, advocates, program participants and other high-level leadership as needed.
This position will also research, analyze, design, and direct implementation of new work flows and project tasks related to routine evaluation of provider performance with the goal of increasing the efficiency, effectiveness, and quality of services provided. Using data, this position will develop, present and analyze data and policies related to provider compliance for Medicaid HCBS programs. This position will research, plan, implement and evaluate special projects resulting from federal and state legislation and guidance, to include integrity monitoring, communicating with internal programs and the Centers for Medicare and Medicaid Service (CMS), using databases, and preparing reports for internal program monitoring. The position will also develop data tracking tools to design and evaluate data metrics to gauge successful strategies for project implementation.
This position develops internal and external communication materials and facilitates data-driven analysis and coordination; responds to program providers, recipients, legislators and other program customers; represents Medicaid and aids at internal and external meetings. As well as all other duties as assigned.
This position operates in a hybrid manner, meaning job duties will be performed both remotely and on-site unless otherwise directed by the appointing authority.