DEPUTY ASSISTANT DIRECTOR, MEDICAL CARE ADMINISTRATION, MEDICAL ASSISTANCE AND HEALTH SERVICES

Code: 61441 Unknown Unknown

Official job specification

The text below is the official specification published by the New Jersey Civil Service Commission. The plain-language summary and analysis above are derived from it by NJ Civil Service Navigator. Source: the official specification page at NJ CSC.

Definition

Under the direction of the Assistant Director, Medical Care Administration, Division of Medical Assistance and Health Services, Department of Human Services, assists in planning, organizing, developing, and supervising the medical care administrative aspects of the Statewide Health Services Program and the general administrative management of the Bureau of Local Administration and the Procedures Development and Communications Unit of the Division; does related work as required.

Examples of work

Provides immediate supervision of the day to day activities of the Chief, Bureau of Local Administration, the Supervisor of the Procedures Development and Communications Unit and the Division's Administrative Practices Officer and assists in supervising other staff reporting to the Assistant Director, Medical Care Administration; assists in supervising the preparation, maintenance and establishment of appropriate records, ratings and fiscal vouchers; and assists in maintaining essential files and other pertinent information pertaining thereto. Serves as official Division liaison with the Social Security Administration, Medical Services Administration (United States Department of Health and Human Services), and the Division of Disability Determinations, Department of Labor for the purpose of solving problems and maintaining ongoing dialogue regarding the Supplemental Security Income (SSI) Program as it relates to Medicaid. Coordinates the federally mandated Early and Periodic Screening Diagnosis and Treatment (PSDT) Program which included staff from Division of Medical Assistance and Health Services, Division of Youth and Family Services, Division of Public Welfare, the 21 County Welfare Boards, the 21 Division of Youth and Family Service District Offices, the United States Department of Health and Human Services, Prudential, Blue Cross and multitude of providers. Serves as a permanent member of the Federal/State EPSDT Task Force. Serves as the official Division liaison with the Division of Public Welfare, Division of Youth and Family Services and the 21 County Welfare Boards for the purpose of coordinating the many facets of the Medicaid/Welfare/Family Service programs administered by the Department of Human Services, the County Welfare Boards and the Division of Youth and Family Services District Offices. Represents Division Director at monthly Division Directors meetings with County Welfare Board Directors and at other meetings and is a permanent member of Division of Public Welfare Manual Policy Committee. Assists in the analyses of medical care administrative practices in local operating offices or field units in order to improve the efficiency of staff operations. Assists in the development of the medical care administrative aspects of the State administered Health Services Program to meet the requirements of Federal legislation and policy and, as assigned, serves as liaison with Federal and State agency representatives relating to health and medical care. Assists in the analysis and interpretation of Federal and State legislation affecting the medical and health related aspects of the program; assists in recommending needed legislation; and assists in maintaining current information on activities and trends in public medical care. Assists in evaluating health needs, trends, and costs in the State and in determining the scope, content, quality, utilization and effectiveness of health and medical care services provided under the program. Assists in maintaining a liaison with State and professional health and related societies, associations and other provider groups in order to interpret the Health Services program and may represent the Assistant Director, Medical Care Administration at these meetings. Assists in maintaining liaison with State agencies such as the Department of Health, the New Jersey Rehabilitation Commission as well as with community welfare and health agencies; helps encourage cooperative activities; participates in State and local efforts to assess health and medical care needs and resources to plan for expansion and improvement, Assists in maintaining liaison with the two Program Contractors (Intermediaries) to ensure consistency of policy and procedure in claims processing operations and provider relations. Assists in overseeing the development and maintenance of manuals of policies and procedures to be used in the operation of the Health Services Program. Participates in the development and promulgation of rates of payment; helps maintain relationships with vendor groups to ensure agreement on reasonableness and methods of payment. Assists in the identification of health and medical care training needs of staff and participates in staff development of these areas. Supervises the work operations and/or functional programs and has responsibility for effectively recommending the hiring, firing, promoting, demoting and/or disciplining of employees. Participates in the design and execution of special studies to assess health needs, gaps in services, and the utilization of available medical-social resources by welfare recipients and the medically needy. Cooperates with other units of the Division by studying the health and medical care aspects of the Program; assists in making recommendations for extending and strengthening services; and participates in developing systems for reporting, storage, retrieval and evaluation of medical care data to provide a basis for improvement and extension of services and for program management. Assists in the preparation of the annual budget request and the annual and other administrative reports required of the Office of the Director. Assists in the development, appraisal and improvement of operational systems and methods of evaluation in relation to quality, costs, fees and allowances; utilization; methods of providing and purchasing health care services, including formal agreements with institutions, agencies and other providers of health services; methods of reporting and medical records maintenance. Arranges for special studies and investigations for the Assistant Director, Medical Care Administration and prepares appropriate reports. Prepares extensive correspondence in the course of official duties; drafts assigned correspondence in reply to inquiries to the Assistant Director, Medical Care Administration from Federal, State and local governmental agencies concerning the Medical Care Program. Prepares clear, technically sound, accurate and informative reports containing findings, conclusions and recommendations. Assists in directing the establishment and maintenance of confidential and other records and files as may be required.

License

Appointees will be required to possess a driver's license valid in New Jersey only if the operation of a vehicle, rather than employee mobility, is necessary to perform the essential duties of the position.

Knowledge, skills and abilities

Considerable knowledge of the principles of medical care administration and familiarity with the varied problems involved in planning and administering the health care aspects of a statewide program of medical care for the indigent and medically needy. Ability to acquire considerable knowledge of the internal organization, programs, responsibilities, standards, policies, and procedures of the Division of Medical Assistance and Health Services, Department of Human Services; and the pertinent State and Federal laws applicable to public welfare medical care program. Ability to acquire considerable knowledge of the agencies of the New Jersey State government responsibility for licensure, registration, approval and/or certification of health care personnel, medical facilities and related health services. Considerable knowledge of individual and institutional practices involved in the provision of medical and other health care services. Considerable knowledge of current social, economic and health problems and resources. Ability to acquire considerable knowledge of the various units within the Federal Department of Health and Human Services and their inter-relationships with State governmental agencies and health programs. Considerable knowledge of the problems involved in furnishing consultation and guidance to technical staff and others, and in working with community leaders to improve the Statewide program of medical and other health care services to the needy. Considerable knowledge of the significance of health problems and the varied methods and devices useful in their solution. Considerable knowledge of Electronic Data Processing applications to medical care payment and information retrieval systems. Ability to utilize input requirements for Electronic Data Processing. Considerable knowledge of modern medical care, health measures and with local community problems related to public medical care for the needy and medically needy Ability to organize and supervise assigned staff, analyze the problems incidental to planning, organize and direct a statewide public medical care program, and develop appropriate work methods. Ability to establish and maintain cooperative working relationships with representatives of Federal and State agencies, executives and individuals, professional associations, providers of services, consultant, and others. Ability to assign and supervise administrative and clerical staff. Ability to keep current with trends in health care, revisions in law and regulations, and with current literature on the broad aspects of medical care administration. Ability to organize assigned administrative and other work designed to assist the Assistant Director, Medical Care Administration. Ability to use English with facility; to speak and write clearly and effectively; to use the English language with skill and discrimination in the preparation of appropriate written material. Ability to analyze medical and social data and make appropriate recommendations. Ability to understand and use medical and related terminology. Ability to prepare and supervise the preparation of technically accurate and comprehensive reports. Ability to supervise the establishment and maintenance of essential records and files. Ability to read, write, speak, understand, and communicate in English sufficiently to perform the duties of this position. American Sign Language or Braille may also be considered as acceptable forms of communication. Persons with mental or physical disabilities are eligible if they can perform the essential functions of the job with or without reasonable accommodation. If the accommodation cannot be made because it would cause the employer undue hardship, such persons may not be eligible.

Note

The examples of work for this title are for illustrative purposes only. A particular position using this title may not perform all duties listed in this job specification. Conversely, all duties performed on the job may not be listed. Applicants must meet one of the following or a combination of both experience and education. Thirty (30) semester hour credits are equal to one (1) year of relevant experience. Nine (9) years of professional experience in a hospital or health agency, responsible for the delivery of medical care services, two (2) years of which shall have been in a supervisory position responsible for the development and implementation of a statewide public assistance medical care program. One (1) year shall have been in a position with administrative responsibility for professional and medical personnel. OR Possession of a bachelor's degree from an accredited college or university; and five (5) years of the above-mentioned professional experience, two (2) years of which shall have been in a supervisory position responsible for the development and implementation of a statewide public assistance medical care program. One (1) year shall have been in a position with administrative responsibility for professional and medical personnel. "Professional experience" refers to work that is creative, analytical, evaluative, and interpretive; requires a range and depth of specialized knowledge of the profession's principles, concepts, theories, and practices; and is performed with the authority to act according to one's own judgment and make accurate and informed decisions.