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Commonwealth of Pennsylvania |
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POSITION DESCRIPTION FOR JOB POSTING |
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Position Number: 50605290 |
Description Activated On: 5/20/2026 8:36:41 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 responsible for providing a full range of policy and regulatory planning, services and system design, and research within OMHSAS. This is completed in collaboration with other state agencies, stakeholder groups, counties, federal agencies, managed care organizations, and community agencies that provide services to individuals with mental illness and substance use disorders. The Division of Behavioral Health Medicaid Policy has the responsibility for management of a wide array of behavioral health Medicaid policy work including In-Lieu of Services, Supplemental Services Review Committee, Value Based Purchasing, Community Based Care Management, PA 67 Waiver, Policy Clarifications, the Medicaid State Plan, HealthChoices Contracts, Medicaid Member Handbooks, supporting maintenance of the Behavioral Health Services Reporting Classification Codes, Mental Health Parity, implementation of federal Final Rule implementation, Medicaid re-entry programs, Federally Qualified Health Centers, Institutions of Mental Diseases, Medial Necessity Criteria, responding to federal Notice of Public Rule Making, HR 1 Implementation, and providing Medicaid expertise for all OMHSAS bulletins, legislative analysis and regulations. The Division also manages an 1115 Medicaid Waiver for substance use disorder. The Division includes two sections, Medicaid Development and Medicaid Program Management. This position serves as the Section Chief for Medicaid Development. The Section of Medicaid Development is responsible for applications for and maintenance of all Federal Medicaid Waivers. This includes the PA 67/1915(b) waiver and any additional waivers, such as 1115 waivers, that OMHSAS pursues. Currently this includes responsibility for an 1115 waiver permitting payment for substance use disorder treatment within an institution of mental disease (IMD) that is valued at $100M to the Commonwealth. The section providers subject matter expertise regarding SUD. In addition, the section is responsible for maintenance of the Medicaid State plan, including identifying and completing state plan amendments as needed. This section has a leadership role in the contract committee, a cross-Bureau working group that establishes contract language for the Behavioral Health HealthChoices agreement with Primary Contractors. This section is responsible for reviewing federal notices of public rule making and final form rules to determine impact on OMHSAS and lead required changes to the behavioral health Medicaid program in Pennsylvania to ensure compliance. This section leads the drafting of policy clarifications, operations memorandum, bulletins and other policy documents related to their areas of expertise. In addition, the section provides input on other policy documents including legislative analysis and regulations related to their areas of expertise. In order to complete these responsibilities, the Section Chief is expected to have the following skills: • Knowledge of the functions and objectives of human services programs, specifically behavioral health and Medicaid programs. • Knowledge of the laws and regulations governing behavioral health services and Medicaid. • Knowledge of available resources for behavioral health Medicaid providers. • Knowledge of the principles and methods of data collection and analysis. • Knowledge of the use and functionality of Microsoft Office Suite software. • Ability to analyze and interpret program and fiscal data related to behavioral health Medicaid. • Ability to analyze and interpret policies, procedures and regulations relevant to behavioral health Medicaid. • Ability to establish and maintain effective working relationships. • Ability to communicate effectively orally. • Ability to communicate effectively in writing. • Ability to lead and motivate staff. |
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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 in this position functions as the Section Chief for Medicaid Development and is responsible for the development and management of professional work related to behavioral health services which includes a full range of supervisory responsibilities; planning and management of current and new initiatives to support the goals of OMHSAS related to Medicaid; reviewing and analyzing Medicaid programs and determining the impact on behavioral health services; consultations, and coordination of all required Medicaid activities under the Division Director for Behavioral Health Medicaid Policy. The incumbent is expected to work in an independent manner and with considerable initiative. The incumbent supervises and directs the work of all staff within the Medicaid Development Section, and specialist contractors when utilized. The Section Chief is responsible for supervising subordinate staff by directing the assignment of work, communication of quality standards and deadlines for assigned work, reviewing staff work products and providing substantive feedback to the employee, supervisory conferences, and evaluation of work performance which includes proactively communicating feedback to staff on their individual performance. The Section Chief is also responsible for employee development, employee training, and employee performance reviews. The Section Chief responsibilities include: • Supervises the analysis and interpretation of federal and state legislation and regulations for program impacts to the behavioral health Medicaid program. • Supervises the analysis of program operations and the development and modification of policies to improve program efficiency and effectiveness for the behavioral health Medicaid program. • Directs the implementation of policies governing programs and services within the behavioral health Medicaid program. • Oversees reviews of behavioral health managed care organizations and other providers to ensure uniformity in interpretation and application of policies and procedures. • Oversees employees evaluating provider policies and offering consultative guidance on the development and revision of policies related to the behavioral health Medicaid program. • Provides guidance and direction to behavioral health managed care organizations to address complex and sensitive non-compliance issues. • Supervises the analysis of systems data to determine accurate policy application for the behavioral health Medicaid program. • Supervises the development and implementation of data collection tools for the behavioral health Medicaid program. • Evaluates adherence to program goals and objectives within the behavioral health Medicaid program. • Provides policy analysis and interpretation to inform the development of requests for proposals and other solicitations and serves on evaluation committees to select providers related to the behavioral health Medicaid program. • Supervises the development and implementation of training programs and policies related to the behavioral health Medicaid program. • Performs the full range of supervisory duties. • Employees in this job may participate in the performance of subordinates’ work consistent with operational or organization requirements. Performs other related 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. 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. The incumbent in this position carries out responsible and professional work under the direction of the Division Director for Behavioral Health Medicaid Policy. Work is performed with limited guidance under the general direction of the Division Director and is reviewed through conferences and reports. |
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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: N/A Licenses, registrations, or certifications: 1. N/A 2. N/A 3. N/A 4. N/A 5. N/A 6. N/A |
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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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