DISTRICT OFFICE MANAGER 1 MEDICAL ASSISTANCE AND HEALTH SERVICES
Career Family: DISTRICT OFFICE MANAGER
District Office Manager 1 Medical Assistance and Health Services is a New Jersey state civil service title.
It lists a bachelor's degree as the baseline, with an experience-based path open to those who do not hold the degree.
How to get hired
- Hiring for District Office Manager 1 Medical Assistance and Health Services follows standard NJ Civil Service procedures. Check the official specification and the NJ CSC jobs portal for the current process.
Read the official specification at NJ Civil Service Commission.
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.
Definition
Under the direction of Regional Director, Medical Care Administration, Division of Medical Assistance and Health Services, Department of Human Services, has complete responsibility for the administration of all aspects of the Medicaid Program in an extremely complex office boundary; assumes responsibility of the office of Regional Director during his/her absence; directly supervises and coordinates the activities of physicians, nurses, pharmacists, social workers, and other office staff in implementing the policies and procedures of the Division; monitors the District Office administrative expenditures; monitors and evaluates patterns of health care delivery for the district office area; implements innovative and/or other special projects; does related work as required.
Examples of work
Directs and supervises all personnel of an extremely complex Medicaid District Office. Supervises the timely preparation and submission of appropriate reports, records, and documents. Maintains close interaction with all staff. Serves as the coordinator at the local level of all complaints either referred by the DMAHS central office or initiated from the provider and recipient communities and/or staff, personally handles all aspects of claims payment process complaints. Is responsible at the local level for the interpretation and implementation of divisional policies and regulations; is administratively responsible for the implementation of policies and procedures at the district level for all Divisional Programs. Is responsible for the scheduling and planning for periodic inspections of institutional facilities; coordination of component medical; nursing, pharmaceutical, and social service staff; preparation of necessary statistical reporting forms, and other documentation for team use on a timely basis. Is responsible for new issuance of Medicaid eligibility cards at the district level on behalf of eligible spouses in need of prompt medical care; interviewing individuals requesting eligibility cards; related contact and referral to Social Security Administration District Office; completion of related transactions to the Medicaid Eligibility File to effect additions, terminations, or corrections; related contacts and statistical reports. Maintains liaison with the county welfare agency (ies), district offices of the Division of Youth and Family Services, Division of Mental Health and Hospitals, Division of Mental Retardation, Division of Public Welfare, Department of Human Services, county representatives, county offices on aging, the Vocational Rehabilitation Commission, and the Social Security Administration district office. Assists and advises direct service casework staff involved in the review and processing of applications for Medicaid. Assists and advises county welfare agency, Division of Youth and Family Services, and Social Security Administration district office staff engaged in establishing and re-determining eligibility. Is responsible for prompt notification to county welfare agencies, Division of Youth and Family Services, and Social Security Administration district offices via established referral procedures of individual status changes affecting eligibility. Receives and coordinates requests from professional staff for data base information concerning Medicaid services provided to clients. Acts as liaison at the District level for computer-generated reports of claims payment which may be available to the public under The Freedom of Information Act. Is responsible for the receipt and prompt administrative disposition of requests for health care services requiring prior authorization, Is responsible for ensuring that applicants/eligible for categorical assistance or Supplemental Security Income, as well as local agencies, are afforded information and applications for the Retroactive Eligibility, Pharmaceutical Assistance to the Aged and Disabled, and Lifeline Programs. Assists individuals in the completion and submission of the application form. Initiates and/or assists in the scheduling and presentation of in-service training and staff development programs. Institutes and coordinates long-term care facility and other provider orientation and training programs at the local level involving medical, nursing, pharmaceutical, child health and social service staff and Division of Medical Assistance and Health Services central office resource personnel. Maintains a local health service resource file. Utilizes resource provider files in the planning and coordination of outreach efforts by county welfare agency, district office of the Division of Youth and Family Services, and Head Start Program staff in the Early, Periodic Screening, Diagnosis and Treatment Program. Utilizes the professional staff of the Division of Medical Assistance and Health Services, Division of Youth and Family Services, Social Security Administration, Vocational Rehabilitation Commission, and county welfare agency caseworkers in the resolution of recipients' health problems. Maintains liaison with public and private health and welfare agencies and providers. Interprets the policies and regulations of programs administered by the Division. Supervises the work operations and/or functional programs of the extremely complex office and has responsibility for effectively recommending the hiring, firing, promoting, demoting and/or disciplining of employees. Maintains administrative liaison with local providers of service with regard to scope of benefits, eligibility and claims processing. Is responsible for the interpretation of Division policies and regulations to providers; assists them to become eligible to participate in the Medicaid Program. Conducts special studies and investigations, and prepares appropriate reports thereon. Assists in the identification of health and medical training needs of staff in an extremely complex District Office and participates in the development of programs in these areas. Prepares accurate and concise correspondence and reports as required in the course of official duties. Supervises the establishment and maintenance of essential records and files. Supervises and directs the staff of the Medicaid District Office who is responsible for implementing the policies and procedures of the division in the areas of medical assistance and health services, adult placement services, medical day care, case management and other community health services, provider recruitment/participation, fiscal and budget management, personnel administration and general administration. Allocates professional, administrative, clerical staff, and resources within an extremely complex District Office to ensure organizational effectiveness. Coordinates and monitors the delivery of all Medicaid related services and activities contracted with county welfare agency (ies) in the county (ies), to assure quality services and compliance with contractual agreements. Provides support in the development of all Medicaid benefit related case management contracts for the county (ies). Supervises the ongoing monitoring and evaluation of all Medicaid provider groups within the county (ies) and recommending priorities for service delivery, and assessing resource allocations. Supervises the implementation of demonstration projects and other projects of experimental or pilot nature as directed. Works with Division professional consultants to assure the availability of professional consultation in areas of quality assurance and program compliance. Serves locally as the focal point and liaison with other public and private agencies in order to encourage cooperative efforts in solving common problems. Assists in the development of plans for effective utilization of existing community resources. Participates with other State and Local departments and agencies in planning and developing new resources. Maintains liaison with representative county provider organizations, medical societies, pharmaceutical associations and other health care disciplines with the county (ies). Is responsible for administrative functions with the county(ies) related to State and Federal program audits such as federal assessments, systems performance reviews, quality assurance surveys, etc., in order to maintain federal financial participation and to assure compliance with State and Federal regulations. Establishes uniform internal procedures to assure uniform and consistent application of the Division's policy for the processing of provider claims which are paid by the fiscal agents. Monitors the volume and quality of health care services within the county (ies) and handles exceptions as they arise. Acts as an authorized spokesperson for the Division's policies and goals at meetings with the public or other State and, Local personnel within the county (ies) and represents the Regional Director as requested. Reviews and evaluates recommendations designed to increase the effectiveness of Divisional programs. Will be required to learn to utilize various types of electronic and/or manual recording and computerized information systems used by the agency, office, or related units.
License
Appointees will l be required to possess a driver's license valid in NJ only if the operation of a vehicle, rather than employee mobility, is necessary to perform essential duties of the position.
Knowledge, skills and abilities
Knowledge of current health care concepts and local community problems related to public medical care for the needy and the medically needy. Thorough knowledge of modern office procedures, systems, and routines and their utilization in an extremely complex Medicaid District Office. Knowledge of the problems involved in providing accurate information to State, County and Local agencies. Knowledge of the problems involved in furnishing consultation and guidance to technical staff and others in an extremely complex office setting. Knowledge of data processing applications to medical care payment and information retrieval systems. Ability to acquire considerable knowledge of the State Data Exchange management information system including coding. Ability to organize administrative work, analyze the operating and other problems of a high level of complexity incident to planning, organizing, and supervising and extremely complex Medicaid District Office and develop appropriate work methods. Ability to assign and supervise the work of professional and clerical staff. Ability to work with community leaders to improve the county-wide program for medical care and other health care services to the needy. Ability to establish and maintain cooperative working relationships with representatives of State and Local agencies, executives, and members of professional associations, providers of services, consultants, and others. Ability to comprehend, interpret, and apply basic laws and regulations. Ability t='left' valign='top' Width='55.5' style='color: SteelBlue' bgcolor='inactivecaptiontext'> Local Class Code
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. Eight (8) years of professional experience as an administrator in a public health services program responsible for the delivery of health care services, two (2) years of which shall have been in a position with county-wide administrative responsibility or supervision of professional or medical personnel. OR Possession of a bachelor's degree from an accredited college or university; and four (4) years of the above-mentioned professional experience, two (2) years which shall have been in a position with county-wide administrative responsibility or supervision of professional or 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.
Study guides for this exam
- Management Test Battery (MTB) National Learning Corporation · $52.95
- Manager/Administrator Test National Learning Corporation · $49.95 · general prep, not specific to this title
The Civil Service Commission does not publish official study guides or release past tests. These are independent equivalency guides.