Administrative Officer II - Escalated Case Resolution Coordinator

About the Role

The Maryland Health Benefit Exchange (MHBE), responsible for administering Maryland Health Connection—the state’s health insurance marketplace under the ACA—is seeking an Administrative Officer II to serve as an Escalated Case Resolution Coordinator. The MHBE partners with various state departments and stakeholders to ensure accessible, affordable health coverage for Maryland residents.

This position is based in Baltimore City, Maryland at grade 14 and contributes to MHBE’s mission of improving health coverage access through customer service, technology, and innovation with values centered on diversity, ethics, collaboration, and innovation.

Key Responsibilities

• Investigate and resolve escalations related to Medicaid, Qualified Health Plans (QHP), and Stand-Alone Dental Plans (SADP), ensuring adherence to applicable federal and state policies.
• Coordinate communication and outreach to affected consumers through phone, email, and secure messaging methods.
• Verify and correct eligibility and enrollment data within HBX and maintain detailed, clear documentation in Salesforce.
• Manage case status updates, generate required transactions, and maintain tracking of cases to ensure prompt follow-ups.
• Act as a subject matter expert on Medicaid, ACA coverage, internal systems like HBX, MMIS, E&E, and Salesforce.
• Collaborate cross-functionally as needed, including assisting with appeals, grievances, and constituent services.
• Provide clear, respectful communication of case outcomes to consumers.
• Support ongoing Consumer Assistance Division operations with task assignments from management.
• Regularly contribute insights to improve agency systems and processes based on case trends and customer feedback.
• Perform other duties as assigned by supervisors within the Consumer Assistance Division.

Qualifications and Experience

Minimum qualifications include a high school diploma or equivalent and at least two years of administrative or professional experience. Candidates may substitute college credit hours, a Bachelor’s degree, or relevant U.S. military service experience for the required experience.

Preferred qualifications encompass at least two years of experience resolving health insurance enrollment discrepancies, working directly with ACA programs such as QHP, Medicaid, APTC, CSR, and SEP, and utilizing health insurance eligibility or enrollment systems to handle complex cases.

Licenses

If applicable duties require driving, a valid Maryland motor vehicle operator’s license is required.

Additional Information

Applications will be accepted online or by mail with a strong preference for the online process. Candidates must provide comprehensive information demonstrating their qualifications by the closing date. Candidates with disabilities, bilingual skills, veterans, and individuals reflecting Maryland's diversity are encouraged to apply. Reasonable accommodations are available upon request.

The employer participates in E-Verify to confirm employment authorization.

Benefits

State of Maryland employee benefits apply.