MEDICAL FACILITIES INSPECTION SUPERVISOR 41196

9/01/90 A

This is the first supervisory class in the Facilities Inspection Management series for positions that supervise Medical Facilities Inspectors or Hospital Utilization Review Analysts who conduct inspections or reviews for the purpose of licensing, certifying or determining compliance with state and federal regulations, policies and procedures. This class is distinguished from the Medical Facilities Assistant Director who has supervision over positions in this class.

Complexity of Work: Performs work of moderate difficulty, supervising inspectors or analysts to ensure that inspections or reviews of health care facilities are performed in accordance with state and federal standards. Reviews and verifies accuracy and completeness of reports and plans of corrections. Meets individually with employees to discuss problems in work performance, standards of conduct or work assignments. Participates in the development, writing and implementation of new or revised regulations. Responds to inquiries regarding claims, regulations or status and condition of existing licensed or certified health care facilities. May manage and monitor automated medical claims processing activities and implement changes to the automated and manual claims processing systems.

Supervision Given: Supervises Medical Facility Inspectors or Utilization Review Analysts Senior. May supervise Secretaries, Program Support Technicians or office support staff.

Supervision Received: Receives directions from a Medical Facility Assistant Director or other program managers who give guidance in new requirements or in the interpre-tation of regulations.

Scope: The scope of activities will affect the licensing and certification of health care facilities throughout the state or payment of Medicaid bills.

Impact of Actions: Work involves dealing with a variety of problems or situations and assessing program effectiveness which will result in the licencing of health care facilities, improving the quality of care given to residents and patients, and the certifying of funds and payment of individual Medicaid bills.

Personal Contacts: Frequent internal and external contact with federal and state Medicaid/Medicare representatives concerning inspection reports. Frequent external contact with administrators on issues resulting from facilities inspection or resolution of billing and claims issues.

Knowledge: Working knowledge of health care operations, management and health delivery systems; principles and practices of supervision; and of automated data processing and medical claims processing.

Skills: None.

Abilities: Demonstrated ability to communicate effectively both orally and in writing; to enforce and interpret federal and state policies and regulations; to supervise the work of others; and to resolve complete health claims processing issues or licensing issues.

QUALIFICATIONS GUIDE*

Licenses or Certification: None.

Education or Training: Graduation from an accredited college or university with major course work in public health administration, health sciences, nursing or a related field.

Level and Type of Experience: Experience in health facility or program management or related institutional inspection programs.

An equivalent combination of training and experience indicating possession of the preceding knowledge and abilities may substitute for this education and experience.

This is a revision of the existing class specification for Medical Facilities Inspection Supervisor, effective September 1990.