The part time (60%) Physician Program Specialist provides medical and technical consultative services to the Medicaid Program in the Maryland Department of Health. The individual will develop and apply medical guidelines, policies and procedures to Medicaid-related issues. The individual is responsible for coordinating and overseeing the reimbursement of all medical surgical services in the Physician Program that are not currently covered by the Medicaid Program, annually updating physician rates and other services rates, approving or denying services that require preauthorization, participating in improving quality processes and providing clinical and technical expertise on where services should be rendered and scope of practice issues. The individual will represent the Medicaid Program at internal and external standing committees and advisory groups and represent the State at the Office of Administration Hearings in appeals cases. The individual will report to the Director of the HealthChoice and Acute Care Administration.
Education: Possession of a degree in medicine from an accredited college or university.
Experience: As required for certification in an area of medical specialization by an American Medical Association Specialty Board.
Note: Candidates may substitute U.S. Armed Forces military service experience as a commissioned officer in Medical Corpsman and Physicians classifications or Nursing or Physician and Medical Services and Special Corpsman Officer specialty codes in the medicine field of work on a year-for-year basis for the required education.
The Maryland Department of Health (MDH) is a governmental agency responsible for providing a wide range of public health services to Maryland residents and its visitors. MDH offers a wide range of job opportunities in many different areas of employment, spanning agencies all over the state of Maryland. To see what opportunities MDH has to offer, visit: http://www.jobaps.com/md.