NC 01787
OSP 2/1/86
DIRECTOR, DIVISION OF MEDICAL ASSISTANCE
This is professional, administrative, and managerial work in directing the administration of the State's
Medicaid program. Employee directs a three quarter billion dollar Medicaid program that provides
medical and health care services to eligible recipients and pays enrolled providers for these services.
Employee is accountable to federal, state, and local governments for all expenditures and directs a
multi-section organization of specialized support programs in Medical Policy and Utilizations Control,
Recipient Services and Provider Relations, Program Integrity, and Financial Operations. Employee is
responsible for setting policy and interpreting precedents within constraints of the rules, regulations,
and statues governing the State's Medicaid System. Employee reports to the Secretary of DHR, but
functions independently because of the complex technical nature of the program.
I. SUPERVISORY/MANAGERIAL FUNCTIONS:
Planning - Employee plans for maximum staff utilization through efficient allocation of staff and
resources, necessary to meet division goals and objectives, with final approval authority in setting and
prioritizing goals and objectives. Legislative changes, new proposals from groups, the state's financial
budget cycle, and general trends in National Medicaid and benefit programs require varying degrees of
planning.
Organizing and Directing - Employee determines overall organization designs and participates in the
development of the work plans for the fo4 major program units through the assistant director level, and
approves all organizational changes made by the Assistant Directors. Direct supervision of employees
is delegated to the Assistant Directors.
Budgeting - Employee develops the complete Medicaid budget by projecting Medicaid services use,
health industry inflation, impact of changes in federal regulations and laws, impact of State Health Plan
and State Health Facilities Plan, and impact of initiative taken by other health care agencies. Employee
monitors legislative changes on program and policies which impact the health care industry and on
indigent care and justifies the Medicaid budget to the Secretary of Human Resources, State Budget
Office and Legislative Appropriation Committees.
Training - Employee approves participation of all division personnel in authorized training programs.
The division has an active program to encourage personnel training in college and graduate courses
and management training programs.
Setting Work Standards - Employee sets and reviews work standards when considering requests for
policy changes, additional personnel and reorganization. Procedures and standards are handled at the
Assistant Director and Section Chiefs levels on a daily basis for final approval.
Reviewing Work - Employee reviews goals and work progress with Deputy Director. Employee focuses
attention on major division objectives as opposed to sections level objectives.
NC 01787
OSP 2/1/86
Counseling and Discipline - All formal personnel actions are reviewed. Problems are reviewed after
other levels of management have been involved.
Performing Other Personnel Functions - Employee interviews all managerial level positions and makes
final decisions on other hires, promotions, and salary adjustments recommended by Assistant
Directors.
II. SCOPE AND NATURE OF WORK SUPERVISED:
Dynamics of Work Supervised - The State's Medicaid program is a very complex governmental
program. It is subject to significant changes on a frequent basis of federal and state laws, eligibility
requirements, new services, reimbursements, co-pay rules, and recipient services. Many changes
require complex and timely actions on the part of the division. Failure to comply with changes could
cause significant loss of federal funds, cause lawsuits, create payment errors, or impose restrictions on
the number of services for Medicaid recipients.
Variety of Work Supervised - Work is financial, administrative, and programmatic in nature; requiring
administrative, professional, and technical supervision.
Number of Employees Responsible for - Employee is responsible for 145 employees, with direct
supervision for four managers.
III. EXTENT OF SUPERVISION RECEIVED: Employee carries out the activities independently due
to the complex nature of the program. Supervision from the Secretary of DHR takes the form of policy
guidance, but is kept informed of discussions where guidance or direction is. Necessary and have
political ramifications or impinge on the Department's goals and objectives. Work is further reviewed
through detailed audits of the Medicaid program by federal and state agencies.
IV. SPECIAL ADDITIONAL CONSIDERATIONS: Not applicable.
V. RECRUITMENT STANDARDS:
Knowledge, Skills, and Abilities - Thorough knowledge of the organization, operations, and objectives
of the Division of Medical Assistance. Thorough knowledge of federal, state, and local laws, statues,
rules and regulations pertinent to directing the Medicaid programs. Thorough understanding of
governmental administration. Considerable knowledge of medical, social service, health care, and
financial programs relative to Medicaid services. Ability to negotiate with statewide medical
associations and private contractors, as well as, with all levels of personnel in the governmental and
private sectors. Ability to render precise written and oral opinions on regulations governing the
Medicaid system. Ability to coordinate and direct employees and programs through an understanding
of managerial principles, techniques, and practices.
Minimum Education and Experience - Master's Degree in Business Administration, Public
Administration, Health Administration, Social Science, or a related field, and six years of progressive
experience in health administration or in financial management, preferably in a human services area,
three of which must have been in a managerial capacity; or an equivalent combination of education
and experience.