Duty Statement, DHS 2388



|duty statement |

|Class Title: |Position Number: |

|Health Program Specialist II (Strengthening Preventative Svcs) (Optional T & D) |805-147-8336-XXX |

|Unit: |

|Section: |

|Branch: |

|Policy and Medical Monitoring |

|Division: |

|Managed Care Quality and Monitoring |

|This position requires the incumbent maintain consistent and regular attendance; communicate effectively (orally and in writing, as appropriate) in 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; and adhere to departmental policies and procedures regarding attendance, leave, and conduct. |

|Job Summary: The Health Program Specialist II (HPS II) has lead responsibility for developing and implementing the quality improvement framework within which the |

|section’s physicians, nurses, and health educators provide technical assistance and oversight of Managed Care Health Plan clinical services. This a highly skilled |

|program consultant in the area of policy development and interpretation related to the Medi-Cal Managed Care program. The HPS II has lead responsibility over developing|

|and writing policy in order to focus on strengthening preventive services for children in Medi-Cal. |

|The HPS II performs functions that are sensitive and critical to the Department’s basic mission, with responsibility to coordinate the development of broad policy that |

|has multidepartment, immediate, and long-range impacts, and where the level of expertise required is substantially greater than that of other nonsupervisory positions. |

|This HPS II position exercises a large degree of independence in serving as the subject matter expert in policy and preventive services for children in Medi-Cal. |

| |

|Supervision Received: Under general supervision of the Branch Chief, Staff Services Manager III. |

|Supervision Exercised: None. |

|Description of Duties:       |

Percent of Time Essential Functions

35% Provides leadership, technical expertise, and direction for preventive services for children in Medi-Cal.. In consultation with clinical staff, creates, executes and continually improves branch processes to effectively and efficiently oversee Medi-Cal managed care plans (MCP) preventive services for children in light of DHCS contract requirements, State and federal laws and regulations, the Department’s Strategy and clinical developments related to preventive services for children.. Based on research, analysis, and consultation, composes communications and reports and convenes workgroups of program stakeholders to implement and coordinate preventive services for children and reviews among the Department’s contracted MCPs. Analyzes proposed legislation and program changes related to preventive services for children. Communicates sensitive and critical program information to all levels of State Government, federal oversight agencies, county governments, health plans, advocacy groups, Medi-Cal members, and other interested parties. Seeks and incorporates clinical input as appropriate. Exercises independent decision-making in resolving issues and problems related to assigned projects and tasks.

35% Leads, facilitates and coordinates complex major health programs and projects within the division related to value based payments (VBPs). Provides consultation to State, Federal and local agencies in the planning, implementation, evaluation and monitoring of health programs, special studies, and projects. Evaluates and researches health policy issues, coordinates health program activities and disseminates information to agencies. Independently develop and implement policies and strategies to oversee the provision of preventive services for children in Medi-Cal managed care plans. Create measurements for compliance and compliance actions such as quality improvement activities, advanced warning letters, Corrective Action Plans (CAPs) and sanctions. Develop and support operational processes and procedures for tracking corrective actions and calculate potential sanctions in the event of chronic noncompliance.

15% Advises DHCS management on the development of policy and data reports that will be useful to DHCS, MCPs and stakeholders. Monitors and reviews MCP policies, quality standards, and guidelines. Trains staff in applying quality improvement methods and principles to MCP preventive services for children programs and coordinates the analysis of policy and data by internal staff. Prepares presentations and briefings for Department Director, Deputy Director, and Division Chief. Participates in recurring teleconferences and meetings with internal and external stakeholders, advocate groups, and provider associations.

10% Assists in the development of personnel and budget reports on critical and sensitive issues for management, the Department of Finance (DOF), and the Legislature.

Percent of Time Marginal Functions

5% Performs other related duties as required.

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

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