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Commonwealth of Pennsylvania |
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POSITION DESCRIPTION FOR JOB POSTING |
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Position Number: 00033971 |
Description Activated On: 1/6/2026 9:33:59 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 incumbent in this position is assigned to the Division of Rate Setting and Auditing, Bureau of Finance, Office of Long Term Living, and may serve as the lead worker and person in charge of the more complex examinations and assigned group of staff. This is advanced professional work and the incumbent performs analytical, developmental and evaluative functions in the examination, evaluation and reporting of public and non-public nursing facilities in all geographic areas of the Commonwealth, various out-of-state provider's Home Office Operations, and/or desk analytical and evaluative functions, as required, to ensure that providers participating in the Medical Assistance Program and providing care and services to medical assistance recipients, are appropriately reimbursed in conformity with Departmental reimbursement policy and regulations. This position may require the incumbent to be in overnight travel status, as required and assigned, in accordance with applicable Commonwealth and Department travel policy and regulations. Work is performed with considerable independence under the direction of an administrative superior utilizing established examination programs and routines and includes either directing the review of work performed by other staff of equal grade or reviewing financial transactions and accounts, provider's financial statements, and applicable agreements, contracts, and regulations, to determine the proper accounting for and allowability of costs. |
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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. - Provides on-the-job training, guidance and assistance on the interpretation and application of Federal, State, and Departmental fiscal and program regulations to assigned staff, in performing examination of service providers' cost reports and statistical and fiscal records. - Generally, does not have immediate access to the supervisor and must act with considerable independence. Assignments are generally specific and distinctive in nature; researches background and general information on the service providers and activities to be examined, determines examination procedures to be used; summarizes and analyzes documentation in order to reach a conclusion on whether acceptable standards of operation were carried out in an economical, effective and efficient manner. Identifies objectives and adjusts examination program as necessary for the review and testing of providers' records and procedures in particular, expanding the scope of the examination to meet objectives, if necessary. - Schedules appointments with service provider administrators, their designated representatives or independent accounting firms charged with fiscal record keeping and financial operations of the facility to explain the reasons and necessity for conducting on-site examinations and to request the materials, data and information necessary to perform the examination. Must frequently explain Departmental policies and regulations to providers. - Reviews and analyzes financial statements, transactions, and accounts to determine control and proper accounting for funds; verifies the accounts and statistical records indicating direct, indirect, ancillary and related organizational costs applicable to resident care; verifies, analyzes, evaluates and substantiates total nursing facility resident costs; determines the reasonableness and amount of actual costs that are allowable for inclusion in the case-mix database in accordance with appropriate policies and regulations and makes adjusting entries as necessary. - Reviews and interprets the Home Office Financial Statements including the Balance Sheet and the related Statements of Income and Expense, Statement of Retained Earnings, and Statement of Changes in Financial Position, for the parent company and all subsidiary companies. Schedule, examine, evaluate and verify the accounts for the parent company and all subsidiary companies that affect the allowability of costs, in particular investment income, and verify income offsets affecting Pennsylvania facilities. Review, analyze and evaluate Home Office expense accounts, noting the percent of change between reporting periods. Review and analyze the Medicare Audit report for the parent company and subsidiary companies, reorganizing and determining the applicability of Medicare audit adjustments to Medicaid regulations, and reconcile Medicaid adjustments to Medicare adjustments. Determine the operating investment income that reduced Home Office costs by Medicare, reinstate the expense, and apply the operating investment income to all subsidiary facilities, reducing allowable operating interest expense. - Analyzes content of completed working paper file and written report for technical soundness and attends and/or conducts entrance and exit conferences with service providers, which may include sensitive contacts with provider representatives in the presentation of examination findings. - Prepares written reports with findings, making necessary adjustments to the service provider's cost report, based upon review and analysis of the examination, then submits for internal approval. - Attends and testifies as an expert witness on Departmental policies and regulations at appeal hearings initiated by service providers relating to allowable costs. - This position description in no implies that these are the only duties to be performed by the employee. Employees are required to follow job-related instructions as requested or directed by their chain-of-command |
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. Work is performed with considerable independence and judgment. Completed work is reviewed by employee's supervisor. |
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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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