Administrative Officer Ii

2 weeks ago

Baltimore, United States State of Maryland Full time

**Introduction**:
The Maryland Health Benefit Exchange (MHBE) is responsible for the administration of Maryland Health Connection, the State's health insurance marketplace, under the Patient Protection and Affordable Care Action of 2010 (ACA). MHBE works with the Maryland Department of Health, the Maryland Insurance Administration, the Department of Human Services, and stakeholders statewide.

MHBE Vision Statement: High-quality, affordable health coverage for all Marylanders. Mission Statement: We improve the health and well-being of Marylanders by connecting them with high-quality, affordable health coverage through innovation, technology, and customer service. Values: Diverse & Inclusive, Innovative, Collaborative, & Ethical

For more information on MBHE please visit our website.

**GRADE**:
14

**LOCATION OF POSITION**:
MHBE is adhering to a hybrid work schedule. Work for this position will be completed at a remote location of your choice (3 days) and at our office located at 750 E. Pratt St, 6th Floor, Baltimore, MD 21202 (2 days).

**Main Purpose of Job**:
The main purpose of this position is to provide support to the Exchange by researching escalated cases, organizing information for review, performing informal resolution for the escalated case as well as outreach to the impacted consumer(s) as needed, accurate reporting and appropriate outcomes. The position reviews eligibility for Insurance Affordability Programs (both Medicaid and Federal subsidies, including special enrollment periods) and ensures all resolutions are accurate and abide by current policy and regulation. This position acts as a Subject Matter Expert (SME) for Medicaid, private health plans, the Affordable Care Act, and internal systems (HBX, MMIS, E&E, SalesForce).

**POSITION DUTIES**:
85% Escalated Case Assignments:

- Receive and perform initial examination of escalated case, working towards resolution of issue/complaint within policy and federal guidelines.
- Perform consumer outreach as needed, within scope of escalated case resolution.
- Properly document case resolution in SalesForce incident, including summaries of actions taken as well as data sources used for determining resolution.
- Proper and correct forwarding of case assignment to other departments (such as MHBE IT, MHBE EDI, MHBE Team, MDH EDD VCL Verification, MDH CRM Retro Medicaid Requests) for continued work on the case and resolution.
- Responding to and taking actions as appropriate on cases deemed as high priority referred to Special Projects for further investigation/resolution.
- Ensure cases are resolved accurately and properly closed in Salesforce utilizing current taxonomy guidelines.

10%
- Monitor and reply to social media contact on the social media platforms maintained by the Exchange (Facebook direct inbox messages, X, Instagram, WhatsApp)
- Address and resolve any consumer concerns/questions in a professional and appropriate manner.

5%
- Performs other duties as required and/or assigned by the Program Manager, Deputy Director, or Director of Consumer Assistance.

**MINIMUM QUALIFICATIONS**:
Education: Graduation from an accredited high school or possession of a high school equivalency certificate.

Experience: Two years of administrative staff or professional work.

Notes:
**DESIRED OR PREFERRED QUALIFICATIONS**:
Knowledge of and experience with Medicaid eligibility

Knowledge of and experience with Qualified Health Plans
- Extensive customer service experience

**LICENSES, REGISTRATIONS AND CERTIFICATIONS**:
Employees in this classification may be assigned duties which require the operation of a motor vehicle. Employees assigned such duties will be required to possess a motor vehicle operator’s license valid in the State of Maryland.

**SELECTION PROCESS**:
**EXAMINATION PROCESS**:
**BENEFITS**:
Contractual employees who work for an agency covered under the State Employee and Retiree Health and Welfare Benefits Program, have a current employment contract and work 30 or more hours a week (or on average 130 hours per month) may be eligible for subsidized health benefits coverage for themselves and their dependents. As a contractual employee, you will be responsible for paying 25% of the premiums for your medical and prescription coverage, including any eligible dependents you have enrolled. The State of Maryland will subsidize the remaining 75% of the cost for these benefits. You can also elect to enroll in dental coverage, accidental death and dismemberment insurance, and life insurance, but will be responsible to pay the full premium for these benefits.

Leave may be granted to a contractual employee who has worked 120 days in a 12 month period. This leave accrues at a rate of one hour for every 30 hours worked, not to exceed 40 hours per calendar year.

**FURTHER INSTRUCTIONS**:

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