09/21/1993 41140

DIRECTOR, BUREAU OF PACE

DEFINITION: This is responsible administrative work managing the operation of the Bureau of Pharmaceutical Assistance Contract for the Elderly (PACE) in the Department of Aging.

The employee in this class is responsible for planning, organizing and managing the operation of the Bureau of PACE. Work involves coordinating and monitoring subcontractor operations to insure compliance with the legal terms and conditions of the contract; managing research and evaluation; conceptualizing and developing cost-cutting programs, such as income verification and on-line claims adjudication; overseeing investigations of fraud and abuse
allegations; serving as a departmental spokesperson to the legislative committees on various facets of PACE operations. Work also involves responding to inquiries regarding the operation of the pharmaceutical program and promulgating regulations and new program ideas. Supervision is exercised over a professional and clerical staff. Work is performed under the general direction of the Secretary or Deputy Secretary and reviewed through reports, conferences and an evaluation of results.

EXAMPLES OF WORK: Plans, organizes and directs the operation of the Bureau of PACE.

Formulates and develops policies affecting the administration of the Pharmaceutical Assistance Program.

Prepares written replies to correspondence and inquiries for own signature and signature of Deputy Secretary, Secretary of Aging and the Governor.

Coordinates and monitors subcontractor operations to insure compliance with the legal terms and conditions of the contract.

Manages and directs a multifaceted research and evaluation activity, using sophisticated computer software.

Develops and manages a retrospective and prospective drug intervention process with medical exception request capacity.

Manages a comprehensive provider audit schedule and field investigation activities.

Reviews provider audits to determine whether questioned costs should be waived or disallowed.

Manages annual match of PACE enrollment records with Department of Revenue's Individual Income Tax Returns; recommends appropriate action where discrepancies are documented.

Manages individual enrollment application processes and adjudication, using imaging applications.

Serves as chief staff liaison to the Pharmaceutical Assistance Review Board (PARB).

Participates in meeting with departmental staff.

Provides consultative services and technical assistance to staff.

Supervises the preparation of data for use in legal proceedings, and the scheduling and holding of public hearings in regard to allegations of abuse/fraud.

Represents the Department on behalf of the Secretary at public functions.

Performs related work as required.

REQUIRED KNOWLEDGES, SKILLS, AND ABILITIES: Knowledge of principles and practices of Federal, State and local government administration and Departmental standards, policies, and procedures governing the administration of aging programs.

Knowledge of legislation and regulations governing the administration of programs for the elderly, medical assistance programs, or similar entitlement programs.

Ability to plan and supervise work of a professional staff.

Ability to coordinate and monitor subcontractor operations to insure compliance with the legal terms and conditions of the contract.

Ability to manage and direct a highly technical research and evaluation process.

Ability to manage and direct a fraud and abuse investigative unit.

Ability to conceptualize and develop new programs and cost-saving ideas.

Ability to read and interpret legislation.

Ability to express ideas clearly and concisely, orally and in writing.

Ability to interpret, evaluate and apply policies and procedures at the Federal, State and local level.

Ability to establish and maintain effective working relationships with associates, government officials, Departmental administrators, subcontractors, legislators, civic, community and professional groups and the general public.

Ability to use good judgment, resourcefulness, diplomacy, and tactfulness in resolving issues regarding the elderly.

MINIMUM EXPERIENCE AND TRAINING: Six years of progressively responsible professional experience in administering or managing aging programs, including two years of supervisory experience, and a bachelor's degree. A master's degree in business administration, public administration, or a related field may be substituted for one year of the required non-supervisory experience;

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Any equivalent combination of experience and training.