Position Description

Commonwealth of Pennsylvania
POSITION DESCRIPTION FOR JOB POSTING
Position Number: 00126440	Description Activated On: 1/30/2026 10:54:35 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 Office of Mental Health and Substance Abuse Services (OMHSAS) is a Program Office within the Department of Human Services (DHS). OMHSAS Bureau of Policy, Planning, and Program Development is organized into three divisions, namely, the Division of Program Management and Planning and the Division of Program Development and the Division of Behavioral Health Policy. The Bureau is responsible for a wide range of policy/regulatory functions that include planning, service and system design, program monitoring and consultation, and development and promotion of evidence-based practices. The Bureau works in collaboration with other state agencies, counties, federal agencies, and private agencies that provide services to individuals with behavioral health needs.

This position is in the Program Management Section of the Division of Program Management and Planning. Staff members in this section are responsible for researching and maintaining knowledge of federal Medicaid policy, federal Medicaid waivers, the HealthChoices Behavioral Health Managed Care Program, the Pennsylvania Medicaid State Plan, and the HealthChoices Reinvestment process. Staff members in the Program Management Section require specific skills to fulfill the job requirements. They must be able to write fact-based, well-structured documents for policymakers, government officials, and public members and effectively communicate policy rationale. Additionally, they must be able to track and analyze data and generate qualitative and quantitative reports using appropriate software applications.

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 incumbent serves as one of the lead staff overseeing various aspects of behavioral health Medicaid services for children, adolescents, and adults, including the HealthChoices Behavioral Health (HC-BH) Managed Care Program. This position develops, reviews, and revises program standards, bulletins, and other documents. The responsibilities include collaboration and consultation with OMHSAS bureaus and field staff to assess the effectiveness of policies and programs, and to ensure consistent implementation. The incumbent also reviews bulletins and regulations related to Medicaid and Managed Care developed by other agencies and program offices to determine their impact on the behavioral health system.

As one of the lead staff in the Program Management Section, the incumbent will oversee or support many of the functions listed below. The Section Chief of Program Management will assign specific responsibilities to each of the lead staff.

• Managing the work involved with the Service System Review Committee (SSRC)
• Representing OMHSAS on interagency and stakeholder workgroups and committees, such as the Medical Assistance Advisory Committee (MAAC) and MAAC subcommittees PH/BH Quarterly Statewide Integration meetings, and the PA 67 Waiver Workgroup
• Representing BPPPD in internal OMHSAS committees such as the Value Based Purchasing (VBP) and Community Based Care Management (CBCM) workgroup, the Medical Necessity Criteria (MNC) Committee, the Behavioral Health Managed Care Contract Committee, and MH Parity Workgroup
• Reviewing and revising HealthChoices Program Standards and Requirements
• Making amendments to the Medicaid State Plan
• Making revisions to and publishing the OMHSAS HealthChoices Member Handbook
• Participating in various types of reviews, including Reinvestment Plans, Service Descriptions, Alternative Payment Arrangements, VBP plans, CBCM plans, and MNC
• Managing or supporting Federal Medicaid Managed Care Waivers and Demonstration Waivers
• Collaborating with OMHSAS Systems Division and the Office of Medical Assistance Programs (OMAP) on coding related initiatives and issues
• Drafting Policy Clarifications
• Reviewing and providing feedback on Federal NPRMs impacting Medicaid services for children, adolescents, and adults
• Reviewing and making recommendations on the substance use disorder (SUD) portion of the County Human Services Plans, Retained Earnings Plans, and County Impact Documents
• Developing, reviewing, and revising existing and new OMHSAS program standards related to SUD to ensure consistency with state law, the Medicaid State Plan, and federal standards and best practices in service delivery
• Reviewing and providing input on the legislative analysis for Senate and House of Representatives bills related to Medicaid, SUD, and services for children and adolescents
• Preparing draft replies to inquiries, public comments, letters, and other correspondence
• Making presentations on Medicaid, SUD, and children and adolescent service-related matters to stakeholder groups
• Maintaining steady communication and working relationships with all OMHSAS bureaus, DHS Program Offices, Commonwealth Agencies, external stakeholders, and contracted consultant partners
• Providing consultation on Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) related matters
• Other related duties 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.

This position works in an independent professional fashion communicating directly with federal and local authorities, other state agencies, managed care organizations, and key OMHSAS staff. Decisions are made with significant independence with concurrence by the supervisor

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:

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Essential Functions: Provide a list of essential functions for this position. Example: Transports boxes weighing up to 60 pounds.

1.	Problem solves issues involving a variety of variables with limited standardization.
2.	Interprets instructions and departmental, state and federal regulations. Interprets trend analysis data.
3.	Communicates with people from a variety of educations and social backgrounds ( ie., healthcare providers, consumers, and office and bureau personnel)
4.	Reviews large volumes of documentations such as regulations, manuals, bulletins, and reports.
5.	Conducts formal training sessions as well as facilitates workgroups and meetings.
6.	Travels, as necessary, in the performance of the aforementioned duties and responsibilities.
7.	Communicates both orally and in writing in a clear, comprehensible fashion
8.	Attends meetings.
9.	Other duties as assigned.
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