To participate in the Bureau of Elderly and Adult Services objectives by providing supervision, planning, direction and oversight of the determination of medical eligibility for nursing facility and Home and Community Based Services 1915 (c) Waiver, Choices for Independence (CFI) in accordance with developed program policy, federal and state requirements. Works collaboratively with other areas in the Department, State, Federal, and community to assure appropriate services and person centered plans for those requiring Long Term Supports and Services.
o Develops reviews, analyzes and evaluates policy development and program procedural implementation in order to effectively deliver long term care program supports and services and substantiate adherence to State and Federal regulations assuring integrity, integration, and consistency across the continuum for persons interested in accessing services.
o Evaluates the allocation of resources for long term care services funded and regulated by the State by reviewing and analyzing data, records, cost of care, caseloads and service utilization in compliance with legal mandates and Department policy.
o Analyzes and evaluates performance data of contractors and staff, and unit operations utilizing information technology to produce reports, interpret information, identify program process strengths and deficiencies, and insure compliance with state and federal performance standards and plan for the achievement of long range Department goals.
o Interprets program policy, rules and laws relating to the delivery of long term care supports and services, represents the department at appeals hearings and may testify on legislative bills to insure consistent and equitable delivery of services.
o Facilitates the discharge planning process for all out of state placements returning to New Hampshire, discharging from New Hampshire Hospital and conducts a utilization review of all individuals residing in atypical units; provides transition planning for all nursing facility residents back to the community and provides critical emergency placement due to unexpected facility closures.
o Prepares grants and or contracts with other agencies or contractors by identifying long term supports and service’s needs, researches supporting documentation and insures the appropriate outcomes for effective delivery of service.
o Provides for and/or arranges for clinical assessment and recommendations for Medicaid Eligibility for admissions to a certified Nursing Facility by consulting with the Preadmission Screening and Annual Resident Review Vendor as well as periodic review.
o Responsible for oversight of Medical Eligibility, including, but not limited to the review and approval of Service Authorizations based on an individualized Person Centered Plan.
o Analyzes staffing requirements, and assumes overall accountability for hiring employees ensuring that the Medical Approval and Authorization Unit maintains a qualified workforce capable of achieving program goals and maintaining federal and state standards.
o Oversees and assures the performance of both skilled medial professional staff and non-clinical staff assigned to the Long Term Care Medical Eligibility Determination Unit including recruitment, training, performance reviews, authorization of leave time, expense reimbursement and scheduling to affect the most efficient use of staff and compliance with policy and program requirements.
o Ensures coordination and collaboration with other Department programs and Divisions.
Master’s degree from an accredited college or university in the health care and/or medical field related to the delivery of Long Term Supports and Services, such as, social work, nursing, human services, psychology, applied sciences, as outlined in 42 C.F.R., 432.50 (d)(l)(ii) or related field.
Five years’ experience in the health care field or a human services related field, three years of which must have been in a management level position involving administrative or supervisory duties concerned with program administration, program planning and evaluation, business management or related management experience.
Bachelor’s degree from an accredited college or university in the health care and/or medical field related to the delivery of Long Term Supports and Services, such as, social work, nursing, human services, psychology, applied sciences, as outlined in 42 C.F.R., 432.50 (d)(l)(ii) or related field.
Six years’ experience in the health care field or a human services related field, three years of which must have been in a management level position involving administrative or supervisory duties concerned with program administration, program planning and evaluation, business management or related management experience.
As required by specific educational area/discipline mentioned above. Valid driver’s license and/or access to transportation for use in statewide travel.
Must be willing to travel statewide.
The supplemental job description lists typical examples of work and is not intended to include every job duty and responsibility specific to a position. An employee may be required to perform other related duties not listed on the supplemental job description provided that such duties are characteristic of that classification.
For further information please contact Kristina Ickes, Administrator IV, KRISTINA.ICKES@DHHS.NH.GOV, 603-271-5035
- TOTAL COMPENSATION INFORMATION
The State of NH total compensation package features an outstanding set of employee benefits, including:
HMO or POS Medical and Prescription Drug Benefits:
The actual value of State-paid health benefits is based on the employee’s union status, and employee per pay period health benefit contributions will vary depending on the type of plan selected.
See this link for details on State-paid health benefits:
Value of State’s share of Employee’s Retirement:
12.15% of pay
o Dental Plan at minimal cost for employees and their families ($500-$1800 value)
o Flexible Spending healthcare and childcare reimbursement accounts
o State defined benefit retirement plan and Deferred Compensation 457(b) plan
o Work/life balance flexible schedules, paid holidays and generous leave plan
o $50,000 state-paid life insurance plus additional low cost group life insurance
o Incentive-based Wellness Program (ability to earn up to $500)
Total Compensation Statement Worksheet:
Want the specifics? Explore the Benefits of State Employment on our website:
Documents that can't be submitted online may be forwarded to:
Department of Health and Human Services- Human Resources
129 Pleasant Street
Concord, NH 03301
Relay NH 1-800-735-2964