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Commonwealth of Pennsylvania |
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POSITION DESCRIPTION FOR JOB POSTING |
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Position Number: 00173703 |
Description Activated On: 1/20/2026 11:36:53 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 works as a Human Services Analyst (HSA) in the Office of Long-Term Living's, Bureau of Coordinated and Integrated Services, Division of Integrated Care Programs. The work requires a strong understanding of Pennsylvania's Living Independence for the Elderly (LIFE) Program. In addition, the position requires the ability to understand participant eligibility and to navigate the Client Information System (CIS), provider enrollment documentation, PROMISe, and other relevant information. This individual is responsible for coordinating and processing enrollments, disenrollments, transfers, and Nursing Facility admissions and discharges of LIFE program participants. With the statewide implementation of the Independent Enrollment Broker (IEB) processing LIFE program enrollments, disenrollments and transfers, the individual is responsible for the oversight and monitoring of the IEB. This individual is responsible for the collection, development and maintenance of data and reporting pertaining to the LIFE providers, applicants, participants, and the IEB. This individual is responsible for the development, implementation and maintenance of regulatory and policy guidance and documents, including policies and procedures for LIFE Program operations. |
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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. Individual must possess a strong understanding of the Living Independence for the Elderly (LIFE) Program. Individual is responsible for the management, monitoring, oversight and processing of the enrollments, disenrollments, and transfers of individuals in the LIFE program. This includes determining individual participant eligibility for enrollment/disenrollment. Possesses knowledge and strong understanding of eligibility categories that would allow or prevent enrollment into the LIFE program. Individual navigates the Client Information System and PROMISe in order to obtain eligibility status and to process requested actions. Individual works closely with the Division's financial representatives, providing leadership through training, technical assistance, guidance and oversight, and manages the coordination of joint section responsibilities. Individual monitors all enrollments, disenrollments and transfers for trends or issues that may need brought to the attention of the Section Chief, Division Director or the LIFE Lead auditors. Individual identifies improperly submitted disenrollments that should be addressed as involuntary disenrollments and should have a strong understanding of the federal regulations regarding involuntary disenrollments. Individual maintains effective working relationships with LIFE Provider Organizations (POs), the IEB, and the CHC Enrollment Unit, and requests additional information and documentation that is needed in order to process either enrollments/disenrollments or transfers. Individual works with LIFE Leads and Clinicians within the division to identify behaviors or trends that should be noted and addressed during state audits. Individual monitors and identifies individuals who are transitioning from LIFE to CHC and from CHC to LIFE and ensures timely processing of their corresponding enrollment/disenrollment. Individual works with participant operations and the IEB to ensure individuals are effectively and timely transitioned between managed care programs. Individual maintains effective working relationship with Bureau of Data and Claims Management to process enrollments/disenrollments through the HealthChoices forms. Individual provides oversight of the IEB for LIFE enrollment, disenrollment, and transfer processing, and develops reports through the regular monitoring of IEB phone calls, In home visit assessments, and LIFE enrollments, disenrollments and transfers. Individual is responsible for the collection, development and maintenance of data and reporting pertaining to the LIFE providers, applicants, participants, and the IEB. Individual identifies, tracks and researches cases on an ongoing or as needed basis. Individual is responsible for the development, implementation and maintenance of regulatory and policy guidance and documents, including policies and procedures for LIFE Program operations. Individual keeps participant files up to date with the most current information as it becomes available. Individual meets with the Section Chief / Division Director and identifies areas for improvement or concern. Individual completes other work 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. General objectives assigned by Section Chief / Division Director. Individual is responsible for decision making regarding individual eligibility of participants for enrollment or disenrollment, and oversight of the IEB in regard to LIFE. Individual determines areas of concern that need brought to the attention of the Division Director and determines areas of concern that should be addressed during state audits. |
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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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