JOB TITLE: DIRECTOR, BUREAU OF COORDINATED AND INTEGRATED SERVICES, OLTL

JOB CODE: 48868

DEFINITION: This is professional and administrative work directing and planning the activities of the Bureau of Coordinated and Integrated Services, Office of Long Term Living (OLTL) in the Department of Human Services (DHS).

The employee in this job is responsible for developing and administering policies for the oversight of managed care organizations providing long term supports and services. Work involves directing the development of regulations, policies, and procedures in compliance with state and federal standards and requirements; ensuring the effective coordination of managed care programs with other departmental program offices, stakeholders, and intergovernmental agencies; and overseeing the review of federal and state legislation to determine the impacts on existing programs and agreements related to Medicare and Medicaid services. Work also involves negotiating agreements with managed care organizations or other vendors and imposing program sanctions and penalties where appropriate. Supervision is exercised over professional staff, and work is performed independently under the general direction of the Deputy Secretary for Long Term Living who reviews work through conferences, reports, and program effectiveness.

EXAMPLES OF WORK: (NOTE: The examples of work are representative of the work, but every position classified to this job may not perform all examples of work listed. Conversely, this is not an all-inclusive list of work examples.):

• Develops and implements policies and procedures for the implementation and oversight of capitated managed care programs.

• Analyzes and interprets federal and state legislation and regulations, and evaluates and assesses impacts on existing agreements with managed care organizations.

• Evaluates program operations, develops recommendations for improvements or new program components, and implements changes.

• Oversees the development and implementation of new long term care delivery models within the long term care spectrum.

• Evaluates the effectiveness of currently administered long term services and supports.

• Oversees the coordination of transition and diversion functions with managed care organizations to ensure individuals are living as independently as possible within the community.

• Works with stakeholders, DHS program offices, as well as the Department of Aging (PDA), to develop, recommend, and implement solutions for improved Medicare/Medicaid coordination.

• Represents the Department in stakeholder meetings and other engagements to report on the performance of managed care organizations, grantees, and other contractors.

• Performs the full range of supervisory duties.

• The employee in this job may participate in the performance of subordinates’ work consistent with operational or organizational requirements.

• Performs related work as required.

ENTRY LEVEL KNOWLEDGES, SKILLS, AND ABILITIES:

• Knowledge of programs, standards, policies, and procedures related to provision of human services and supports.

• Knowledge of goals, objectives, principles, and practices of human service administration and program operations.

• Knowledge of the laws and regulations governing human services.

• Knowledge of the principles and practices of employee supervision.

• Ability to analyze, interpret, and evaluate policies, procedures, and regulations.

• Ability to establish and maintain effective working relationships.

• Ability to communicate effectively orally.

• Ability to communicate effectively in writing.

MINIMUM EXPERIENCE AND TRAINING: (NOTE: Based on the Entry Level Knowledges, Skills, and Abilities):

• Six years of professional experience in a human services program, including three years of supervisory experience, and a bachelor's degree;

or

• An equivalent combination of experience and training which includes three years of supervisory experience in a human services program.