PROFESSIONAL EXPERIENCE

Confidential

Medical Care Program Associate Supervisor

Responsibilities:

• Plans, coordinates, supervises and evaluates the work of lower level Medical Care Program Associates, to ensure staff perform job duties, in accordance with MDH MCHP job aides and conditions of awards.
• Develops improvements or modifications to operating procedures and policies, to ensure compliance, according to MDH guidelines and COMAR.
• Assists with interpretation of COMAR and ACA as it related to Medicaid eligibility.
• Maintains the MCHP policy and procedure manual to ensure that all policies and procedures are current according to the MDH job aides and guidelines.
• Performs the supervisory duties for MCHP staff to maintain the work of MCHP staff, according to MDH rules and regulations.
• Reviews and determines client eligibility for medical assistance programs, according to COMAR and MDH guidelines.
• Internal super user access for the Maryland Health Connection (HBX).
• Assisted program manager with the MCHP budget.
• Attend monthly and quarterly supervisor meetings.
• Prepares monthly, quarterly, and annual MCHP reports.
• Created a procedure and streamline automated process for the SRS audits.
• Writes MS access queries.
• Trainer:
• Develops training material.
• Trains MCPA I, MCPA II, MCPA Lead, and MCPA Supervisors on policies, procedures, and systems.
• Complete SRS reviews while worker/supervisor is in training.
• Facilitates pop up trainings as needed.
• Run mini training sessions for staff as needed.
• Create procedures and how to documents.
• Maintains and updates the MCHP Manual.
• Creates activities and icebreakers for the MCHP staff meetings.

Confidential

Medical Care Program Associate Lead

Responsibilities:

• Determines initial and/or continuing eligibility for recipients by applying program eligibility rules and regulations to the information submitted by the applicant to determine Medicaid eligibility.
• Contacts applicants via mail, email, or phone to obtain and verify information relevant to eligibility determinations.
• Data systems, reports, and data entry - Enters, codes, and maintains data in an automated information system to determine applicant eligibility.
• Assist with interpretation of COMAR and ACA as it related to Medicaid eligibility.
• Training - Trains new and current employees regarding program eligibility changes.
• Knowledge of policy, rules and regulations - Interprets, applies, and processes program specific information, policies, regulations, and guidelines.
• Customer Service - Handles routine telephone and mail inquiries; provide courteous, professional and confidential assistance to all clients seeking health benefits; refers applicants to support services as appropriate; responds to inquiries and complaints and provides liaison services to health care providers, insurance companies, other governmental agencies and recipients, contacts insurance companies, health care providers, other governmental agencies and recipients in order to verify information submitted to the medical care program for payment or review; handle sensitive and personal information with an understanding and respect for client confidentiality.
• Assigns and reviews the work of the MCHP staff - Assigns and reviews the work of the MCHP staff according to MDH guidelines and protocol. Provides professional leadership, guidance, and consultation to clerical staff. Holds monthly meetings with the clerical staff to discuss program updates, quality assurance, and to exchange current programmatic information. Plans for continuing education needs of assigned staff; orients new staff to the unit by reviewing policies and procedures and provides training.
• Work on special projects as assigned by the supervisor.
• Attend outreach events throughout the year.
• Works with IT team to determine system fixes and workarounds for ongoing system issues.
• Completes overrides in the system when needed to fix applications.
• Assisted program manager with monthly and annual reporting.

Confidential

Outreach Worker

Responsibilities:

• Provide benefits screening and application assistance for enrollment in Medicaid and Maryland Children’s Health Program using the Maryland Health Connection system.
• Conduct marketing and outreach within the local communities about accessing Medicaid and qualified health plans (QHP) through the Maryland Health Connection.
• Make appropriate referrals for other needed services.
• Maintain case files for recipients with proper documentation and verifications.
• Maintain state assister certification.
• Attend trainings, updates and meetings as required by Maryland Department of Health and the Maryland Health Connection.
• Was the lead in working through system fixes and workarounds on the Maryland Health Connection.

Confidential

Human Resources Information Systems Analyst

Responsibilities:

• Created and implemented 15 SQL server databases.
• Administer over 30 SQL server 2000 databases for Human Resources users.
• Proficient in design and development of tables, stored procedures, views, DTS, security, and SQL programming language.
• Provide daily systems support to Education, Health Services, Employment, and Communications.
• Coordinate and manage numerous MS Access databases for the education program administration.
• Managed United Way campaign database.
• Managed bank wide applicant tracking system, Resumix, for 120 users.
• Experienced in system development methodology including developing high-level project plans, detailed timelines, required deliverables, and core team responsibilities.
• Designated team leader for several “high profile” initiatives that resulted in operating efficiencies.
• Managed several projects requiring daily direction of project team including managers and peers to ensure desired project deliverables are met within strict deadlines.
• Managed the design and development of the consolidated compensation web based officer merit and secretary bonus systems.
• Managed division wide migration from Seagate 7 to Crystal Enterprise 8.0 web reporting system resulting in 200% operating efficiency.
• Managed upgrade from Resumix 5.3.0.4 to Resumix 6.2 impacting 110 users.
• Assisted with upgrade from PeopleSoft HRMS 7.6 to web based 8.0.
• Assisted with implementation of automated time and attendance system (Kronos) pilot for credit and compensation division.