Program Manager (Western PA)

Job Description

Job Description

SUMMARY

The Program Manager is responsible for the administration, oversight, and coordination of Agency programs to ensure operational effectiveness, regulatory compliance, and quality service delivery. This position applies professional knowledge of federal, state, CHC, and Agency regulations to monitor program performance, conduct quality assurance activities, and recommend corrective actions. The Program Manager supervises the Programs Department and collaborates with the Quality Compliance and Assurance Officer to ensure compliance with all applicable laws, regulations, and Agency standards.

Essential Functions: Listed below are the functions performed with or without reasonable accommodation. Other duties may be assigned based on business necessity.

• Oversees service coordination activities across all assigned programs to ensure compliance with contractual, regulatory, and Agency requirements.
• Supervises the Programs Department, including defining staff responsibilities, authority, and accountability.
• Manages daily program operations and assigned office areas.
• Provides performance management, professional development, and corrective action in coordination with Human Resources.
• Ensures consistent supervision, coaching, and evaluation of program supervisors and staff.
• Monitors service coordination effectiveness and conducts random audits to ensure regulatory compliance.
• Serves as a secondary point of contact for participant grievances and supports investigation and resolution.
• Collaborates with the Claims Analyst to ensure timely follow-up and resolution of outstanding accounts receivable related to participant services.
• Reviews consumer service plans and assists with documentation and regulatory submissions.
• Conducts and oversees quality assurance reviews and internal audits in accordance with regulatory standards.
• Communicates program updates, operational guidance, and recommendations to staff, participants, providers, and community stakeholders.
• Establishes and maintains professional relationships with provider agencies and external partners.
• Assists Management with budget monitoring and compliance.
• Supports internal controls and procedures that promote effective communication and interdepartmental collaboration.
• Participates in the development, implementation, and evaluation of short- and long-term program goals.
• Ensures all program operations comply with Agency policies, procedures, and ethical standards.
• Reviews regulatory notices and supports implementation of required program changes.
• Assists in the development and revision of program-related policies and procedures.
• Participates in ongoing training and professional development activities.

ADDITIONAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned.

• Participates in on-call responsibilities as assigned.
• May provide professional instruction, mentoring, or field guidance to peers as appropriate.
• Performs other related duties as assigned by Management.
• Travel is required, including occasional overnight travel for training or professional activities.

Additional Responsibilities:

1. Manages on-call duties.
2. May be responsible for providing field instruction for peers of their respective professional discipline, as opportunities permit.
3. Performs additional related duties as assigned by Management.
4. Travel is required, including occasional overnights for training and seminars.

Knowledge, Skills, and Abilities:

• 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. Advanced knowledge acquired by a prolonged course of specialized intellectual instruction and requiring regular exercise of discretion and judgment. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functionAdvanced professional knowledge requires the exercise of independent judgment and discretion.
• Strong leadership, supervisory, and interpersonal skills.
• Ability to work independently with minimal supervision.
• Demonstrated commitment to quality improvement and customer service.
• Strong organizational, analytical, and problem-solving skills.
• Attention to detail and accuracy in written, oral, and numerical work.
• Ability to function effectively in high-pressure environments.
• Knowledge of community-based services, healthcare systems, and human service resources.
• Proficiency in the use of computers and standard business software.
• Ability to adhere to professional ethical standards and Agency policies.

Qualifications:

• A Master's Degree from a four-year college or university in a Social or Human Services or related field is required (i.e., social work, psychology, etc.).
• Demonstrated supervisory experience overseeing CHC and MCO waivers and DHS programs
• Experience with Managed Care Organization program management.
• Valid Driver's License.
• Personal vehicle for day-to-day job performance due to making home visits requiring frequent local and occasional state-wide travel.
• Must be able to pass all background checks.

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 accommodations may be made to enable individuals with disabilities to perform essential functions. While performing the duties of this job:

• The employee must be able to handle high-stress situations on a day-to-day basis.
• The employee must be able to make judgment decisions and communicate clearly.
• The employee is frequently required to walk and sit.
• The employee is required to stand and reach with hands and arms.

Work Environment:

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions. While performing the duties of this job:

• Work is performed in office, community, and field settings.
• Frequent exposure to outdoor weather conditions and variable driving environments.
• Noise level is typically minimal to moderate.

Employment is contingent on the successful completion of the following clearances

• PA State Police Background Check (e-PATCH)

• Child Abuse Clearance

• FBI Background Check

• MA Fraud Check

• Social Security Verification

• DMV Check