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Commonwealth of Pennsylvania |
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POSITION DESCRIPTION FOR JOB POSTING |
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Position Number: 00088968 |
Description Activated On: 2/14/2025 1:42:47 PM |
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. This position is located in the Office of Medical Assistance Programs, Bureau of Fee-for-Service Programs, Division of Provider Enrollment. The incumbent is responsible for approving or certifying providers for enrollment with the Medical Assistance (MA) Program. This position is responsible for Program related activities for the Division of Provider Enrollment, including interpreting state and federal regulations that affect the enrollment process. The incumbent is responsible for documentation of process changes and quality reviews of enrollment processing data. Staff members in this position are responsible for training and support of other provider enrollment staff. |
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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. 1. Reviews and enrolls provider enrollment applications. 2. Responsible for the review and analysis of Medical Assistance Program objectives, regulations, and policies as they relate to enrollment by maintaining a system for evaluation and interpretation, and implementation to ensure compatibility and program compliance. 3. Research and respond in writing to enrollment interpretations, questions, complaints, or inquiries on enrollment related issues received from providers, legislators, provider associations and legal services organizations. Preparations of responses requires intensive research, a thorough understanding of Medical Assistance Program policy and enrollment procedures, and an understanding of the Department’s Enrollment system. Responses must be reviewed by a supervisor prior to being sent out of the Provider Enrollment Unit as they are frequently prepared for the Secretary, Deputy Secretary, Bureau Director and Division Director. 4. Serves on interdepartmental workgroups, leads meetings and works as a team member within Provider Enrollment. 5. Answers Provider Enrollment Service Center calls and assists in the resolution of Question and Answer forms that are generated from Service Center phone calls. 6. Provides technical assistance and recommendations to program office staff on complex enrollment issues and sensitive high-profile situations based on policies and regulations to ensure timely, accurate, and complete resolutions to enrollment related problems. 7. Responsible for the timeliness and accuracy of information posted to the Provider Enrollment Webpage relating to provider enrollment. 8. Performs Quality reviews for enrollment staff members to ensure data integrity within the provider enrollment system. 9.Work on special projects as assigned to the Bureau including new Department initiatives and implementation of new Federal and State regulations affecting the provider enrollment process. 10.Represent the Department in provider hearings and appeals Performs other related duties and special projects as assigned. |
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. General instructions and assignments are given by the supervisor. Latitude is afforded in completing the tasks assigned. Work results are reviewed periodically. |
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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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