Duty Statement, DHS 2388



|duty statement |

|Class Title: |Position Number |

|Staff Services Analyst (SSA) |805-258-5157-702 |

|Unit |

|Cal-ARM Innovation |

|Section |

|Business Innovation |

|Branch |

|Business Innovation |

|Division |

|Third Party Liability and Recovery (TPLRD) |

|Job Expectations: The Staff Services Analyst (SSA) must maintain consistent and regular attendance; communicate effectively orally and in writing when dealing with the |

|public and/or other employees; develop and maintain knowledge and skill related to specific tasks, methodologies, materials, tools and equipment; complete assignments |

|in a timely and efficient manner; adhere to departmental policies and procedures regarding attendance, leave, and conduct; and ensure strict confidentiality of member’s|

|Protected Health Information (PHI) in accordance with the Health Insurance Portability and Accountability Act (HIPAA) and other established rules and regulations. The |

|incumbent must accept increasing responsibility and changing work priorities; perform at a high level; provide high quality work products; pay attention to details in |

|written documents; reason logically and creatively; use various analytical techniques to resolve complex problems; develop and evaluate alternatives; accurately present|

|data, statistics, and conclusions; have effective interpersonal skills; and consult with and advise management or other staff on a wide variety of subject-matter areas.|

|The SSA must be able to use independent judgment and discretion to interpret and apply state and federal laws, regulations, policies and procedures. |

| |

|Job Summary: Under the general supervision of the Staff Services Manager I and unit lead(s), the incumbent performs a variety of administrative, analytical, and |

|technical tasks to ensure compliance with federal and state laws, rules, and regulations regarding the recovery of debts, and generates savings for the State General |

|Fund. The incumbent participates in and helps to lead unit activities, and ensures adequate administrative and accounting controls for the TPLRD process. The incumbent|

|provides analytical support for TPLRD, which cost avoids, collects, and recover debts owed on Medicaid recovery claims against settlements, estates, special need |

|trusts, and other sources. |

| |

|The incumbent is also responsible for SharePoint collaboration workflows, Automated Collection Management System (ACMS), California Medicaid Management Information |

|System (CA-MMIS) functions, the output of Enterprise Innovation & Technology Services (EITS) Division jobs, and other Department of Health Care Services (DHCS) systems.|

|Acting as TPLRD SharePoint contributor, the incumbent participates in and assists with the development, testing and implementation of any current or future workflow |

|modules within SharePoint. Assists with the use of current technical tools for section staff such as Management Information System/Decision Support System (MIS/DSS), |

|ACMS, Medi-Cal Eligibility Data System (MEDS), Interwoven and AutoForms. Perform analysis on data. Work on projects related to technical enhancements and continuously |

|promote innovation and efficiencies throughout TPLRD. |

| |

|Supervision Received: General supervision from a Staff Services Manager I, Chief, Business Innovation Unit |

| |

|Supervision Exercised: None |

| |

|Description of Duties: See Below |

Percent of Time Essential Functions

25% Perform eligibility and health care data analysis from appropriate resources, including MEDS, MIS/DSS, Surveillance and Utilization Review System (SURS), managed care plans, and other public or private agencies when necessary. Maintain knowledge of data sources and processes to serve as a subject matter expert for TPLRD. With assistance from management and unit lead(s), work on data analysis and research with other DHCS Divisions pertaining to data or other functions that have a direct impact or benefit to TPLRD.

25% Analyze claim and encounter data to create an itemization of Medi-Cal payments subject to recovery. Assist with maintenance of the MIS/DSS Business Objects templates for the functional areas within TPLRD and provide support to MIS/DSS users within TPLRD as needed. Provide recommended MIS/DSS data improvements to DHCS’s MIS/DSS contractor when appropriate.

20% Assist with updates and construction of new features for TPLRD SharePoint. Assist other TPLRD staff with SharePoint development as needed or requested by management. Coordinate with TPLRD staff and management to development, test, and implement TPLRD process improvement projects. Ensure that all process improvements keep TPLRD activities in compliance with policies, laws, rules and regulations. With assistance from management and unit lead(s), coordinate with staff and management within DHCS, other state and county agencies, or outside contractors as appropriate or applicable to the current work load and project list.

20% Draft formal responses to controlled, sensitive, or technical correspondence for management’s review and signature. Draft and present statistical reports and analysis of data regarding TPLRD activities for management review. Prepare documents such as legal bill analysis, budget change proposals, issue papers, monthly collections activity, and other reports. Provide data and/or statistics for reports as needed by TPLRD management. Review changes in federal and state laws, regulations, and policies and document any impact to recovery programs. Assist with preparation changes to and/or draft new federal or state legislation and regulations, write unit procedures, and perform other analytical and/or technical assignments.

5% Assist management and unit lead(s) with providing basic on-the-job training, and help coordinate advanced training, pertaining to the software, systems, process, methodologies and procedures for all TPLRD staff.

Percent of Time Marginal Functions

5% Perform other duties as required within the specifications of the class.

| |

|Employee’s signature |Date |Supervisor’ signature |Date |

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