SENIOR MEDICAL SERVICES SPECIALIST 2642

DISTINGUISHING FEATURES OF THE CLASS

An employee in this class performs responsible work in the performance of program management duties in a designated unit. Work includes responsibility for the formulation, initiation and interpretation of policies and procedures as well as supervision of subordinate staff consisting of professionals, paraprofessionals and clericals engaged in the implementation and monitoring of numerous health related programs. The employee may act as a liaison between the department and other departments, divisions and the general public. The work is performed under general supervision and is reviewed by an administrative superior through conferences and reports for conformance with departmental regulations and policies. The incumbent is expected to exercise considerable independent judgment and initiative in the performance of duties. Does related work as required.

TYPICAL WORK ACTIVITIES

Schedules and supervises the work of Medical Services Specialists, Caseworkers, paraprofessionals and/or clerical staff;

Develops and audits health related programs and conducts seminars for the medical review staff and/or other agency personnel;

Provides professional support to administrative superiors and other medical professionals;

Prepares monthly reports and provides statistics concerning medical assistance program to administrative superiors in the department;

Revises or recommends revisions to policies and procedures to comply with Federal and State mandated requirements in the administration of medical assistance programs;

May develop, implement and evaluate special projects within a medical assistance program;

Analyzes costs and devises programs to reduce costs by improving administrative methods and identifying provider and client misutilization;

Reviews and approves certification and recertification of health care providers and the admission of medical assistance clients to health care facilities;

Coordinates outreach programs and monitors delivery of care in a medical assistance program;

Represents the agency at hearings and meetings, both within government and in the community;

Maintains liaison with community groups, other government agencies and professionals connected with medical assistance programs;

Refers medical assistance clients for other needed services and makes referrals for investigation of fraud or abuse;

May disseminate information and literature to the community about programs administered by the department.

FULL PERFORMANCE KNOWLEDGES, SKILLS, ABILITIES AND PERSONAL CHARACTERISTICS

Thorough knowledge of the procedures used in medical diagnosis and treatment; thorough knowledge of the medical terminology used by physicians and other medical personnel; thorough knowledge of local, State and Federal laws affecting social welfare, medical and health programs; good knowledge of the community, its resources and its health needs; ability to plan, assign and supervise the work of subordinates in a manner conducive to full performance and high morale; ability to establish and maintain effective working relationships with medical professionals, agency personnel and members of the community; ability to express oneself clearly and concisely, both orally and in writing; physical condition commensurate with the demands of the position.

MINIMUM QUALIFICATIONS

OPEN COMPETITIVE

Graduation from a college with federally-authorized accreditation or registration by NY State with a Bachelor's or a Master's Degree in Nursing or other health or human services field, plus four (4) years of experience as a registered professional nurse in home health care and/or the review of health care services for medical necessity including at least two (2) years of home health care experience or experience in the supervision of preventive health programs which was gained within the last ten (10) years.

PROMOTIONAL

One (1) year of permanent competitive status as a Medical Services Specialist.

NECESSARY SPECIAL REQUIREMENT

At the time of appointment and during employment in this title, employees must possess a Registered Nurse's license issued by the State of New York.

Employees must also possess and maintain a valid license to operate a motor vehicle in New York State.

R05/15/06

SUFFOLK COUNTY

Competitive

Review 7/23/15