|
Commonwealth of Pennsylvania |
|
|
POSITION DESCRIPTION FOR JOB POSTING |
|
|
Position Number: 00174165 |
Description Activated On: 7/29/2026 3:54:43 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, in the Bureau of Family Health, Division of Child and Adult Health Services, is responsible for assisting with the administration of the Chronic Renal Disease Program (CRDP), specifically monitoring transportation service providers and applications and ensuring that operation is consistent with applicable laws, as well as Division, Bureau, and Department policies and procedures. |
|
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. PROCUREMENT OVERSIGHT: Assists with the preparation of grant agreements and contracts in accordance with Department protocols and timelines including: Manages Transportation grant agreements, in accordance with Department procurement procedures, including developing a Request for Applications to select grantees, developing work statements and grant agreement budgets, and serving as a Project Officer on selected grants. Monitors grantee activities and reviews and verifies that invoices are submitted for allowable costs and in accordance with payment provisions. Provides technical assistance to providers for efficient implementation of services. Processing CRDP transportation applications, including maintaining monthly re-enrollments in the CRDP transportation program, sending out re-enrollment packets, tracking re-enrollments, and the processing of re-enrollment applications for CRDP transportation. Tracks the status of existing medical PPAs, notifying providers in advance of expiration dates, receiving and processing completed agreements from new and existing providers as well as reviewing and addressing any inaccuracies or questions for completion, submitting appropriate documentation to the Office of Procurement, and tracking the status of PPAs. PROGRAM ADMINISTRATION: Collaborates with the CRDP Administrator in developing, assessing, implementing, and evaluating all CRDP protocols to maintain or increase effectiveness. This includes but is not limited to using invoice and payment data to track trends in utilization and population needs and making recommendations for program modification and improvement. Assists with the oversight of cardholder eligibility, reimbursement of services, HIPAA related issues, and the development and utilization of automated systems. This includes: •Training CRDP staff on all aspects of electronic invoice processing submitted by providers; •auditing invoices adjudicated by other staff to assure for accuracy, rejecting incorrectly paid invoices, providing staff with technical assistance regarding inaccuracies and maintaining a record of incorrectly processed claims for quality control purposes; •creating a general invoice to have claims paid to providers who submitted a reconsideration request as appropriate; and, •reviewing invoices prepared by staff that are not payable through the Core System for accuracy, submitting them to the CRDP administrator for signature, and working with the Division’s Administrative Officer to submit the invoices for payment. Serves as the primary customer service agent by independently utilizing various resources such as the Core System, DHS's automated PROMISe system, eCIS and the Department of Aging's automated Prime Therapeutics system to independently answer telephone inquiries received from cardholders and providers pertaining to eligibility periods, status of invoice reimbursements, availability of provider, questions concerning reimbursable or denied services, etc. Makes independent judgements and decisions based on available information in order to respond to cardholder and provider needs. Consults with CRDP Administrator and/or Manager on an as needed basis for unresolved issues. Assists with the facilitation of the Renal Disease Advisory Committee including scheduling and preparing for meetings, drafting meeting minutes. Prepares and coordinates completion of application and approval memos for nomination of committee members. Assists in conveying, interpreting, and explaining the CRDP’s services, reimbursement policies, procedures, forms, and approved fees to providers, CRDP cardholders, staff, others as requested. Researches and prepares responses to inquiries related to the CRDP. Develops record keeping and reporting systems designed to evaluate CRDP effectiveness and efficiency. Utilizes this data for programmatic planning purposes and to prepare recommendations for change as necessary. Prepares letters, memos, and reports to and for Division Director, Bureau Director, the Deputy Secretary and the Secretary of Health. Assists with invoicing processing as needed. GENERAL: Remains current on issues related to chronic renal disease through attendance and participation in conferences and meetings; independent reading and research; and other forums to recommend appropriate action for incorporation into CRDP activities. Maintains confidentiality of any Protected Health Information (PHI) encountered during the performance of job duties pursuant to the Health Insurance Portability and Accountability Act (HIPAA), which limits the disclosure of this information. Performs other related duties as required to meet the goals of the Division of Child and Adult Health Services, the Bureau of Family Health and the Department of Health. Public Health Emergency Response – This position may be given an assignment to support the public health emergency response mission of the Department of Health. Emergency assignments could at times be received with little or no advance notice and may continue for any period of time – ranging from a few hours to several weeks, depending on the nature of the circumstance. The emergency assignments may at times be performed under adverse conditions and may require travel to another site other than the employee’s assigned headquarters for a period of time. Health Equity – Demonstrate awareness of the vulnerable populations the organization serves by identifying, providing, and advocating for resources, services, communication methods, and policies that would help those populations achieve health equity. |
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. Individual works collaboratively with the CRDP Administrator regarding assigned duties for CRDP administration as well as works directly and independently with providers and cardholders to establish PPAs and resolve questions relative to billing issues. Advises CRDP Administrator regarding operations and collaboratively resolves issues of a routine nature related to the CRDP based on established and approved policies. Seeks guidance from the Administrator or Manager as needed. Independence is exercised for daily/routine responsibilities. Problems and concerns are discussed with the CRDP Administrator and Supervisor. Supervision is received through regular progress meetings and the review of completed work. |
||||||||||||||||||||
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.
|