GRADE
STD0020
LOCATION OF POSITION
MDH Developmental Disabilities Administration Baltimore MD
Main Purpose of Job
The Program Manager for Program Compliance and Integrity provides leadership and oversight for the Developmental Disabilities Administrations (DDA) Medicaid Home and Community-Based Services (HCBS) waiver program and state-funded services. This position leads the development implementation and evaluation of DDAs quality compliance and program integrity framework to ensure services are delivered in accordance with federal and State requirements. This position promotes a culture of compliance accountability equity and continuous improvement across the organization.
The position oversees quality assurance quality improvement compliance monitoring and program integrity activities including efforts to prevent detect and address fraud waste abuse and improper payments. Responsibilities include establishing performance standards and outcomes identifying systemic risks overseeing corrective actions and providing technical assistance to strengthen provider and program performance.
The position ensures compliance with CMS HCBS waiver assurances and federal quality evidence collection performance measure reporting remediation activities andfederally required reporting necessary to maintain waiver approval and federal : Waiver assurance reports submitted timely and accurately. Evidence reports meet CMS requirements. Remediation activities are completed according to approved waiver methodologies. Federal and State audit requests are addressed within required timeframes.
This position serves as DDAs lead for CMS waiver assurance and HCBS program integrity requirements ensuring compliance with federal regulations related to participant health and welfare provider qualifications incident management financial accountability and person-centered service delivery.
This position is responsible for monitoring and reporting waiver performance measures preparing federally required evidence reports coordinating audit and oversight activities and leading quality improvement initiatives. The position coordinates and leads Regional Office Quality Enhancement teams oversees Office of Health Care Quality performance measures and assists with administrative duties for the DDA Waiver Advisory Council.
This position is subject to hybrid working conditions for the purpose of teleworking at a minimum of two (2) days per week.
MINIMUM QUALIFICATIONS
Qualified candidate must possess a Bachelors or Masters degree in Healthcare Administration Public Health Business Finance or related field from an accredited college or university and six years of health or human services administrative or professional experience including three years at a supervisory or managerial level. Qualified candidates must also possess at least two years of work experience handling fraud waste and abuse matters.
A Masters degree from an accredited college or university substitutes for one year of the general experience and a Doctorate substitutes for two years of the general experience. Additional experience substitutes for the college degree on a year-for-year basis.
DESIRED OR PREFERRED QUALIFICATIONS
Desired candidates should possess experience in the following:
1. Risk Management: Proven experience conducting risk assessments compliance reviews and program integrity activities.
2. Data Literacy: Ability to analyze large sets of financial or programmatic data to identify aberrant billing practices anomalies and risk indicators.
3. Reporting: Strong written and verbal skills for developing policies guidance and training materials as well as briefing senior stakeholders.
SELECTION PROCESS
This is a Management Service position and serves at the pleasure of the Appointing Authority. A resume must be uploaded to the application.
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 it is essential that you provide complete and accurate information on your report all related education experience dates and hours of 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 submitted after this date will not be added.
Incorrect application forms will not be accepted.
Candidates may remain on thecertified 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
FURTHER INSTRUCTIONS
Online applications are highly recommended. However if you are unable to apply onlinethe paper application (and supplemental questionnaire) may be submitted to MDH Recruitment and Selection Division 201 W. Preston St. Room 114-B Baltimore MD 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 informationto .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 theMDH Recruitment and Selection Division at .
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 or.
Appropriate accommodations for individuals with disabilities are available upon request by calling: or MD TTY Relay Service 1-.
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 States diversity.
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