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Commonwealth of Pennsylvania |
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POSITION DESCRIPTION FOR JOB POSTING |
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Position Number: 00233433 |
Description Activated On: 5/8/2026 12:23:40 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 is a professional, management position located in the School-Based ACCESS Program (SBAP) Unit within the Division of Operations and Communications, Bureau of Policy, Analysis and Planning. The incumbent is responsible for reviewing, analyzing and evaluating statewide Medical Assistance (MA) policies related to MA benefit coverage for MA-eligible school children, aged 3 through 20 years of age, and state and federal initiatives related to delivery of health-related services in the school setting. The SBAP specifically supports MA beneficiary children who are also persons with disabilities, receiving services under the Individuals with Disabilities Education Act (IDEA). The incumbent is also responsible for aspects of planning, analysis, policy and program development related to the daily operation of the SBAP including: the Random Moment Time Study, Fee-for-Service interim claiming, and support for day-to-day Local Education Agency (LEA) customer support. |
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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. The incumbent is responsible for developing and writing policies pertinent to the delivery and/or payment of MA services across all delivery systems. Functions and decisions must be performed/made independently in discharging these duties. Specific responsibilities include but are not limited to the following: A. Review, interpret and analyze Federal and State laws and regulations and court decisions impacting the MA Program’s delivery systems for the purpose of providing comments on proposed documents and to determine the necessity for revising Departmental policies for compliance. B. Analyze and interpret Federal and State regulations and guidelines to develop and write or modify policies and procedures to be followed for services rendered to MA recipients or to be followed by providers when billing the Department for services rendered to MA beneficiaries. The development and writing of policies and procedures includes the existing SBAP as well as any expansion of the SBAP or addition of new school-based programs which the Department intends to implement. C. Maintain responsibility for the development, revision, interpretation and clarification of MA Program policies and procedures related to MA-enrolled children, with special emphasis on children with disabilities. D. Analyze and evaluate objectives of the MA Program in conjunction with the objectives and requirements of the IDEA to allow for effective administration and coordination of operational activities for LEAs. E. Conduct research, collect, and evaluate information used as a basis for writing policy and procedures. F. Prepare State Plan Amendments. G. Review documents prepared by other agencies for accuracy and conformance with MA Program policies. H. Participate in both Departmental and extra-Departmental meetings where MA Program representation is required. I. Prepare briefing materials for the Governor, the Secretary of Human Services and other executive staff. J. Develop draft documents and program materials and schedule necessary meetings to facilitate internal review, including with the Office of General Counsel. K. Evaluate and consolidate applicable comments gathered during internal review and prepare final documents for executive review and approval. L. Monitor, evaluate and analyze program operations. Advise and provide recommendations to Supervisor of SBAP Unit and other executive level staff as to methods of resolving program problems. M. Research and respond to inquiries regarding issues of program policy or interpretation and complaints or inquiries received from providers, legislators and legal service organizations. Preparation of responses requires extensive research and a thorough understanding of the policies, operations and procedures of the MA Program and the SBAP. Responses are frequently prepared for the Secretary, Deputy Secretary, Bureau Director and Division Director. N. Develop MA bulletins to clarify existing policies or to implement new policies or programs. This task includes policy and systems research; coordination of input from a variety of Departmental and other program offices as well as writing the bulletin. O. Prepare or assist in the preparation of reports, background papers, budget narratives and survey responses regarding the MA Program, and comment on the impact of legislative initiatives on the MA Program, with special emphasis on initiatives related to delivery of services in the school setting. P. Affect the Department decision-making process by participating in numerous implementation committees. Initiate research, analyze data and prepare recommendations on provider impact, cost and time requirements involving the enactment of major program and systems changes for assigned provider types in order to effectively plan, implement, and notify providers of any necessary changes to the MA Program. Q. Prepare edits and updates to the SBAP provider handbook and develop training materials for LEAs to support their understanding of program policy. Coordinate activities regarding the issuance of handbooks and posting of program materials to the DHS SBAP webpage in order to ensure LEAs have access to current, accurate information necessary to understand and bill the MA Program. R. Design and direct special studies by identifying issues; coordinating the collection of data with various sources and preparing written reports summarizing findings and recommending problem resolution in order to effectively plan provider training sessions. S. Coordinate the resolution of various issues and program problems by planning and conducting meetings with Department staff and collateral staff in order to ensure the efficiency and effectiveness of provider billing regulations. T. Represent the Department to providers and provider associations by preparing and delivering presentations in order to establish and maintain a professional working relationship with these entities. U. Obtain documents, conduct research, answer interrogatories and give testimony at both administrative and judicial hearings relative to MA Program/ SBAP issues. V. Provide staff support within the Bureau of Policy, Analysis and Planning and the Department to affect the enhancement of major changes and to effectively plan, implement and notify appropriate entities of any necessary changes related to the MA Program. W. Perform 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. This position requires a great deal of independence and judgement to perform tasks and on the projects that the individual in this position is assigned, which includes the review, research, analysis, and interpretation of MA Program policy and initiatives, Federal and State laws, regulations and guidelines, applications, amendments, and renewals to 1915(b) waivers, and responses to correspondence. The individual is responsible for making decisions to ensure efficient and effective day-to-day operations and works independently, obtaining supervisory guidance on the most complex, sensitive or precedent setting issues. The individual in this position consults with the supervisor on any issue dealing with policy decisions that deviate from the normal processes/procedures, works independently within assigned program areas and manages priorities and workload to meet established goals. Although performance of duties and responsibilities is governed by established policies, procedures and regulations, the individual in this position exercises considerable independence, initiative, and judgment in their application. The individual in this position discusses technical and problem areas will be discussed with the supervisor; however, day-to-day operations are the individual's responsibility. The individual in this position is required to independently prioritize work on a daily basis to ensure deadlines are met. Work may be unpredictable at times, requiring the individual to change priorities as needed. When problems with meeting deadlines or conflicting priorities occur, the individual in this position seeks advice from the supervisor. The individual in this position is expected to use independent judgement to solve day-to-day problems and issues that arise and to meet the established responsibilities of this position. Because this individual’s work impacts, reinforces or sets the Department's Office of Medical Assistance Programs policy or regulations, draft documents/recommendations are completed and forwarded to the supervisor, Section Chief, Division Director and Bureau Director for review and approval. In response to assigned work, the individual works independently to analyze the assignment, research the issue, and prepare response for the supervisor's approval. Responses are based upon history, findings, and future directions of the Office of Medical Assistance Programs in accordance with agency policy, procedures, goals and objectives. |
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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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