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Commonwealth of Pennsylvania |
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POSITION DESCRIPTION FOR JOB POSTING |
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Position Number: 50704981 |
Description Activated On: 9/9/2026 3:00:14 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 performs professional work involving the implementation, coordination, evaluation, and oversight of statewide grievance system operations, regulatory administration activities, and Home and Community-Based Services compliance initiatives within the Office of Developmental Programs, Bureau of Community Services. Work includes interpretation and operationalization of federal and state regulatory requirements relating to HCBS access, beneficiary protections, grievance procedures, accessibility requirements, provider oversight, and quality management systems affecting individuals receiving services through Medicaid-funded and state-funded human service programs. The employee participates in the development, implementation, and evaluation of statewide grievance system procedures and related oversight processes to ensure compliance with Centers for Medicare and Medicaid Services requirements, including requirements relating to beneficiary access, procedural protections, accessibility, documentation, recordkeeping, and resolution timelines. Work includes evaluating operational practices, identifying compliance risks, supporting implementation of corrective actions and quality improvement initiatives, and providing consultation and technical assistance to providers, Administrative Entities, Supports Coordination Organizations, and other stakeholders regarding regulatory requirements and grievance system operations. The employee participates in regulatory administration and program accountability activities through review and analysis of provider, administrative, and programmatic operations; evaluation of complaints, grievances, incidents, and related documentation; participation in development of policies, procedures, and operational guidance; and coordination of enterprise systems and processes supporting oversight, monitoring, and compliance functions. Work is performed under the general supervision of a higher-level program supervisor or manager. |
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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. Interprets and applies federal and state statutes, regulations, waiver requirements, policies, and procedures relating to Home and Community-Based Services, Medicaid beneficiary protections, grievance systems, accessibility requirements, provider oversight, and regulatory administration activities. Participates in the development, implementation, and evaluation of statewide grievance system policies, procedures, operational guidance, workflows, and related program materials to support compliance with federal HCBS access and grievance system requirements. Coordinates and supports grievance intake, tracking, review, resolution, documentation, and recordkeeping activities relating to complaints or expressions of dissatisfaction associated with the provision, oversight, or administration of HCBS and related human services. Reviews complaints, grievances, provider documentation, administrative records, monitoring findings, service documentation, incident reports, and related materials to determine compliance with applicable regulatory and programmatic requirements and to identify operational concerns, systemic trends, or potential risks affecting individuals receiving services. Provides consultation, technical assistance, and regulatory interpretation to providers, Administrative Entities, Supports Coordination Organizations, advocacy organizations, and other stakeholders regarding grievance system requirements, accessibility obligations, beneficiary protections, provider responsibilities, operational practices, and compliance expectations. Participates in the review and evaluation of grievance-related evidence, case records, medical or service documentation, and investigative materials for purposes of supporting grievance resolution activities, regulatory oversight, quality improvement efforts, and compliance determinations. Coordinates with ODP staff, providers, Administrative Entities, Supports Coordination Organizations, legal staff, quality management staff, incident management staff, and other oversight entities regarding grievance resolution activities, procedural requirements, corrective action planning, and related compliance matters. Participates in activities relating to accessibility and beneficiary accommodations, including ensuring meaningful access to grievance systems and related processes for individuals with disabilities and individuals with Limited English Proficiency through the use of auxiliary aids, interpreter services, translated materials, accessible communication methods, and related supports. Assists in the development, implementation, evaluation, and ongoing refinement of enterprise systems, databases, reporting processes, tracking mechanisms, and related technology solutions supporting grievance system administration, regulatory oversight, quality management, and program accountability activities. Reviews and analyzes grievance data, complaint trends, monitoring information, provider practices, operational processes, and related system information to identify patterns, compliance concerns, systemic issues, and opportunities for quality improvement. Participates in the development of reports, correspondence, training materials, procedural guidance, presentations, and recommendations relating to grievance systems, regulatory administration, HCBS access requirements, provider oversight, and program operations. Supports ODP and DHS staff with development, tracking, and validation of Statements of Findings related to noncompliance with applicable state and federal regulations. Ensuring documentation accurately reflects investigative results, regulatory citations, required corrective actions, and compliance expectations. Coordinates with ODP and DHS staff to confirm accuracy of cited regulatory requirements, validate evidence supporting findings, and reconcile any discrepancies prior to finalization. Provide training and technical assistance to internal and external stakeholders and provider types regarding Performance Based Contracting and similar initiatives. Provides training and technical assistance to internal staff and external stakeholders regarding grievance procedures, regulatory requirements, beneficiary protections, accessibility standards, documentation expectations, and related operational processes. Participates in policy development, quality management activities, program evaluation studies, corrective action initiatives, and operational planning efforts relating to statewide HCBS oversight, grievance systems, and regulatory compliance functions. May participate in onsite reviews, virtual meetings, interviews, complaint reviews, monitoring activities, or investigative activities relating to grievances, provider oversight, accessibility concerns, beneficiary protections, or regulatory compliance matters. May participate in procurement, contract coordination, interagency initiatives, stakeholder workgroups, or enterprise implementation activities related to grievance systems, oversight functions, accessibility compliance, or program accountability operations. Performs all other 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. Exercises independent judgment in reviewing grievances, complaints, provider documentation, operational practices, and regulatory compliance matters within established policy and procedural requirements. Makes decisions regarding prioritization of grievance-related activities, requests for additional documentation or clarification, coordination of reviews, identification of compliance concerns, and recommendations relating to operational improvements, corrective actions, or regulatory follow-up activities. Participates in the interpretation and operational implementation of federal and state grievance system requirements, HCBS access requirements, accessibility standards, and related programmatic guidance in consultation with supervisory staff and program leadership. Assists in identifying system enhancement needs, operational challenges, reporting requirements, and process improvement opportunities relating to grievance systems, enterprise technology, regulatory oversight, and program accountability functions. |
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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. 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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