|
Commonwealth of Pennsylvania |
|
|
POSITION DESCRIPTION FOR JOB POSTING |
|
|
Position Number: 00146037 |
Description Activated On: 9/12/2023 3:07:46 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. Provides various administrative and program support for the Bureau of Medical Care Availability and Reduction of Error (Mcare), including performing ongoing program evaluation, managing special projects, and managing compliance efforts. |
|
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. Analyzes bureau operations to identify issues and opportunities for improvements. Develops and coordinates the implementation of recommendations to establish or revise bureau policies and procedures to improve operations. Evaluates and comments on legislative matters impacting Mcare and provides input and recommendations on legislative language development. Develops the operational coverage compliance plan of Mcare to support the program area goals. Presents plan to Mcare management team for review. Analyzes, interprets, and recommends revisions to compliance program policies and procedures to Coverage Director and Executive Director, and assures implementation in conjunction with coverage unit staff to include use of coverage system tools and metrics. Develops directives and guidance on compliance requirements to be published in public-facing documents and internal manuals. Performs public relations duties virtually or in-person to increase awareness of compliance directed at healthcare providers and insurers. Develops and maintains a report that identifies noncompliant health care providers by researching and utilizing information from Department of State and Department of Health reports and public sources. Researches, analyzes, and prepares reports on various data and provides feedback on compliance to management by healthcare provider name and type from review of Mcare operating system reports. Develops and maintains an active list of compliance issues in coordination with AO1. Conducts routine meetings with senior staff to present compliance metrics. Formulates, recommends, and implements internal and external communications concerning health care provider’s compliance status. Serves as liaison on compliance issues with health care providers, insurers, and program staff to address key coverage issues and assess options. Designs and distributes training material for coverage unit staff on compliance duties and responsibilities. Provides training and education on coverage obligations and applicable laws. Prepares Mcare’s Annual Report by developing statistical data and information from program areas. Manages project deadlines by monitoring and tracking key administrative issues critical to the operation of Mcare as assigned by the bureau director. Develops position papers on issues that could potentially impact Mcare. Coordinates or conducts special projects in support of Mcare operations. Serves as Mcare 's web site and content administrator by determining content and coordinating placement on Department website. Serves as Mcare’s right to know coordinator working with Department Counsel to respond to inquiries. Serves as Mcare’s record retention coordinator by facilitating the management of records in accordance with the record retention requirements. Serves as a member of the management project study team, responsible for strategic planning. Respond to inquiries from both internal and external parties as assigned. Performs other duties 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. Work is performed independently and is reviewed for compliance with Mcare Fund directives, policies, and procedures. Decisions that could have significant impact on program operations are discussed with and approved by Mcare’s bureau director prior to taking action. |
||||||||||||||||||||
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. |
||||||||||||||||||||
Essential Functions: Provide a list of essential functions for this position. Example: Transports boxes weighing up to 60 pounds.
|