Program Representative
- Harrisburg, PA
- Contract
- Full-time
- The employee is part of the Division of Program Operations, Bureau of Community Services (BCS) and will be supervised by Charles Frick.
- The employee in this position performs coordination and administration work for the Bureau of Community Services to ensure compliance with Federal and State regulations, policies and procedures, and understanding of the goals and initiatives of ODP.
- Evaluates and assesses the quality of community programs, services, and supports through on-site visits and the review of records to assure that individual’s needs are identified and met through the QA&I review process and/or ad hoc monitoring as needed
- Ensures fidelity to Supports Intensity Scale (SIS) protocols. Supports the discrepancy review process.
- Monitor compliance with EPSDT requirements for Medicaid-eligible individuals under 21. Collaborate with Managed Care Organizations (MCOs), providers, Administrative Entities and other stakeholders to resolve EPSDT issues and promote transition to adult services.
- Review and analyze IM4Q data for trends and systemic concerns. Support stakeholder engagement and communication and training related to IM4Q.
- Participate in and support Provider Applicant Orientation (PAO). Review provider applicant materials, monitor timelines and maintain accurate records of provider applicant statuses and inquiries. Provide technical assistance to provider applicants, providers and Administrative Entities (AEs).
- Respond to inquires and concerns from individuals, families, providers and other stakeholders. Document and track issues to ensure timely resolution. Provide policy clarification and referrals to appropriate ODP resources.
- Coordinates and collaborates with service coordinators, providers, participants, family members, other departments, and advocacy groups through on-site visits, training, conferences, and team meetings.
- Assists Charles Frick with managing Information Technology (IT) projects including work involving HCSIS, PROMISe, and the future Enterprise Case Management (ECM) system. Responsibilities include but are not limited to, providing technical assistance, participation in meetings regarding design and implementation of new functions, review documents, testing prior to implementation, troubleshooting, providing and participating in training to the field, and provide feedback as required or in other areas as required.
- Collaborates with other DHS offices, other non-DHS offices, legislative offices, and community organizations to communicate the philosophy and initiatives of the Bureau of Community Services.
- Responsible for oversight of program activities, plan reviews and approvals, administration, and analysis of the BCS Intellectual and Developmental Disabilities and Autism (ID/A) program, including on-site reviews, data collection and investigations, monitoring for compliance of both state and federal policies and procedures and preparing reports of the findings.
- Directs and/or participates in the development, coordination, implementation and validation of corrective action plans to address any problems identified through annual and ongoing monitoring.
- Applies sound principles in collecting information/data, both routinely and on an ad hoc basis, and interprets and analyzes information to assess compliance with contractual, regulatory, and departmental standards.
- Assures accurate maintenance of statistical data needed to prepare periodic internal and annual CMS reports.
- Provides assistance to providers regarding rates and billing.
- Represents ODP at meetings, conferences, including committees, work groups, certain advisory boards and councils, and advocacy organizations. Accurately assesses and report community and participant concerns and interests to ODP.
- Responds to inquiries both in writing and verbally.
- Perform other duties as assigned.