Company name
Maryland Department of Health Boards
Experience
8 yrs required
Location
Baltimore, MD, United States
Employment Type
Full-Time
Industry
Legal
Posted on
Aug 22, 2020
Profile
Chief, Health Insurance And Managed Care (repost)
The candidate will provide leadership regarding health insurance and Health Maintenance Organization (HMO) related issues for the Division. Will assist the Associate Commissioner of Life and Health with the implementation of the Affordable Care Act (ACA) and provides guidance to staff on the impact of the ACA on policy form review. This position oversees the management of the Life and Health Division’s Health Review and the Managed Care Units, which are responsible for the review and approval of all health and managed care contracts in Maryland, including provider contracts. This position also assigns Utilization Review Analysts new and renewal Private Review Agent (PRA) and Medical Director applications for review to determine compliance with Maryland laws and regulations, and evaluates the quality of review performed. This position assists the Associate Commissioner of Life and Health with the analysis and interpretation of proposed state and federal legislation and regulations, and acts as the Associate Commissioner’s designee, if needed, at meetings and by providing testimony during the legislative session. Will be responsible for integrating new legislation and regulations into the form review process and PRA and medical director certification process, and assisting with the drafting of any necessary regulations, bulletins, checklists, and training materials for staff. Advises the Associate Commissioner of Life and Health on numerous health insurance issues impacting consumers and insurance carriers, and answers technical questions from consumers, insurance carriers, and MIA staff regarding filing requirements and other complex health insurance issues.
Additional Information
Recruitment #20-009646-0001. Submit a cover letter stating interest and specific salary requirements; and a current professional resume as WORD or PDF file.
Company info
Maryland Department of Health Boards
201 W. Preston Street Herbert R. OConor State, Office Building
Baltimore
Maryland
United States 21201
Website : https://health.maryland.gov/Pages/boards.ASPX