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Commonwealth of Pennsylvania |
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POSITION DESCRIPTION FOR JOB POSTING |
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Position Number: 00005082 |
Description Activated On: 11/12/2025 8:49:15 AM |
Position Purpose: Describe the primary purpose of this position and how it contributes to the organization’s objectives. Example: Provides clerical and office support within the Division to ensure its operations are conducted efficiently and effectively. The employee in this position is responsible for the supervision of the Division of Operations & Communications within the Bureau of Policy, Analysis and Planning, Office of Medical Assistance Programs (OMAP), Department of Human Services. Supervision includes all aspects of planning, policy and program management, including the development and maintenance of the regulatory and operational base for federally and state funded physical health Medical Assistance (MA) Program services. Supervision also includes oversight of the procedure coding evaluation for the development and maintenance of MA Program Fee Schedule. |
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Description of Duties: Describe in detail the duties and responsibilities assigned to this position. Descriptions should include the major end result of the task. Example: Types correspondence, reports, and other various documents from handwritten drafts for review and signature of the supervisor. The Division is comprised of two sections: Operations and Communications and Procedure Coding Evaluation and Support Section. This position reports directly to the bureau director and is responsible for the supervision of a Human Services Program Executive One section chief and a Medical Facility Records Examiner Supervisor and overall work of the Division. This position requires strong analytical and interpretative ability, independent judgement and significant initiative as it requires developing and recommending policy positions and guidance, direct involvement in the development of operational procedures, provider payment rates and automated systems applications; planning, organizing, directing the development, implementation, and maintenance of program policy, including the issuance of directives and procedures, and promulgation of regulations; and development of user designs for automated systems. Work involves extensive coordination of policy and program development, fiscal management, electronic data processing systems applications, federal and state officials, providers, professional associations, beneficiaries, advocates, staff of all levels, both within and outside of OMAP and the Department. Work includes directing the analysis of current and proposed federal and state legislation and regulation and evaluating the impact to MA Program services; developing state mandates, program goals, and initiatives, maintaining specific sections of Pennsylvania’s Medicaid State Plan; determining the need for automated data systems support and initiating the appropriate actions. Directs or supports the development and issuance of operational directives and procedures. Monitors service expenditures and utilization and designs and develops regulatory and operational proposals; includes evaluating and analyzing reports and identifying program needs in order to prepare budget proposals and supporting documentation for the Bureau Director. Recommends development and revision of program goals, objectives, policies, regulations, procedures, and standards in order to ensure that specific services of the MA Program are administered accurately, effectively and efficiently meet services needs of the program and align with federal and state law, rules, regulation and policy. Develops and maintains segments of Pennsylvania’s Medicaid State Plan by directing the development and processing of amendments according to federal requirements to ensure eligibility for federal matching funds. Also provides guidance and support to other program offices in the development and maintenance of their areas of responsibility in the State Plan. Provides oversight, guidance and support in the development and maintenance of the Medical Assistance Program Fee Schedule performed by the Procedure Coding Evaluation and Support Section. Oversees Operations and Communications Section which serves as the intake area for policy inquiries, legislative analyses, correspondence, and coordination with the Division of Policy and Research for policy research and program development and maintenance. Confers with providers, beneficiaries, advocates, other program managers, and staff to develop and implement program improvements and modifications. Reviews new developments in medical technology and recommends changes to the scope of covered services in order to ensure continued provision of comprehensive health care and related services. Directs the development of user requirements and designs for supporting automated systems, interfaces with other departmental and vendor staff, participates in testing and approves systems as meeting operational, management information and reporting requirements. Directs the development and maintains statistical reports used to evaluate and develop policies and program administration. Directs the development and promulgation of state regulations to comply with governing mandates and reflect program changes and needs. Chairs and participates in research and advisory groups which include representatives of private and public interest groups and inter- and intra- departmental staff to provide oversight, recommendations and advice on existing and new program initiatives. Provides information and direction by serving on special committees and workgroups in order to formulate future directions and to represent the interest of the MA Program and clients served. Testifies at provider hearings, trials and other administrative proceedings as an expert witness by explaining the development and interpretation of policies, regulations and procedures in order to represent the Department’s position. Supports the Department’s activities in relation to federal and state audits. Manages day-to-day operations by establishing objectives to be achieved, prioritizing and assigning tasks in line with available resources, providing leadership and oversight for accurate and timely completion of tasks and initiatives. Performs related work as required. Travels as required. |
Decision Making: Describe the types of decisions made by the incumbent of this position and the types of decisions referred to others. Identify the problems or issues that can be resolved at the level of this position, versus those that must be referred to the supervisor. Example: In response to a customer inquiry, this work involves researching the status of an activity and preparing a formal response for the supervisor’s signature. Directs section supervisors in developing and maintaining programs, communications, policies, regulations, automated systems, procedures and forms. Evaluates the job performance of section supervisors and other subordinates. Provides for and develops on-the-job and other training to ensure the organization’s capacity of accomplishing work requirements and meeting program goals and objectives. |
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Requirements Profile: Identify any specific experience or requirements, such as a licensure, registration, or certification, which may be necessary to perform the functions of the position. Position-specific requirements should be consistent with a Special Requirement or other criteria identified in the classification specification covering this position. Example: Experience using Java; Professional Engineer License Experience: Licenses, registrations, or certifications: 1. N/A 2. N/A 3. N/A 4. 5. 6. |
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Essential Functions: Provide a list of essential functions for this position. Example: Transports boxes weighing up to 60 pounds.
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