What are the responsibilities and job description for the Developmental Disabilities Program Specialist I - ISP/Utilization Review position at Montgomery County Pennsylvania?
SUMMARY
The Program Specialist 1 assists in the management of the Developmental Disability program and participates in ongoing activities related to compliance with the Administrative Entity Operating Agreement, including but not limited to Provider Risk Screening, Risk / Incident Management, and Review, Approval and authorization of Individual Support Plans and monitoring of utilization of ID / A Waiver Services.
ESSENTIAL DUTIES AND RESPONSIBILITIES
Provide technical assistance and consultation to provider agencies regarding system issues, including but not limited to ODP and County policies and procedures.
- Monitor the review, approval and authorization of ISPs to ensure an appropriate level of waiver service to address documented and current assessed needs.
- Work with the SCO Liaison to provide feedback to Supports Coordination Organizations to address issues with ISPs reviews, level of services suggestions and utilization reviews.
- Support the PS 2 in the review of utilization of authorized service for the determination of capacity management.
- Assist PS 2 in identifying billing issues or delays affecting the claims processing and accurate utilization reporting.
- Complete activities related to compliance with the Administrative Entity Operating Agreement.
- Work with provider agencies and other stakeholders to address issues / concerns related to participants Health / Safety
- Participate in activities that support Risk Management within Health and Human Services, such as participating in PCHC activities and the Quality and Incident Management review committees.
- Participate in the Provider Risk Screening process, reviewing records and providing feedback on provider strengths and needs.
- Participate in supporting the Quality Assessment and Improvement process.
- Represents the County at community outreach events on an as needed basis; this may include doing presentations on the DD system to stakeholders in a variety of settings.
- Supports an environment that encourages teamwork and morale.
- Accepts other duties as delegated.
QUALIFICATION REQUIREMENTS
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and / or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.
MUST MEET ONE OF THE FOLLOWING CRITERIA :
SKILLS :
PHYSICAL DEMANDS
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is regularly required to stand; walk; sit; and talk and hear. The employee is occasionally required to use hands to finger, handle or feel objects, tools or controls; reach with hands or arms; and stoop, kneel, crouch or crawl. The employee must occasionally lift and / or move up to 25 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision and depth perception. Some travel is required.
WORK ENVIRONMENT : The work environment characteristics described here are representative of those an employee counters while performing the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential function. The noise level in the work environment is usually moderate.
