Public Health Program Associate 1

Full Job Description

Requirements

As a Public Health Program Associate 1, you will become involved with reporting, complaint and grievance resolution, enforcement actions, application and contract review, appeals, network filings, investigations, and quality assurance processes.

You will be responsible for organizing documents needed to review provider contracts, integrated delivery service arrangements, service area expansions, new applications for HMOs or gatekeeper PPOs, and health insurer network adequacy.

Within this role, you may also have the opportunity to assist in preparing cases at complaint/grievance committee meetings and participate as a member of the complaint/grievance committee.

Additional responsibilities include:

• Reviewing applications for completeness and compliance with applicable laws, regulations, statements of policy, and guidelines
• Responding to questions by collaborating with the team, researching, and reviewing existing documentation, regulations, and laws
• Organizing inbound requests for service area and expansion requests seeking to operate in new geographic regions of the state
• Observing the advisory group meetings, identifying compliance issues in consumer appeals
• Learning how to build consumer appeal case files, present cases to peers, participate in case review, and draft decision letters to plans and consumers
• Assist with preparing certificate of authority applications for review that are submitted by health maintenance organizations (HMOs) for licensure in Pennsylvania

Interested in learning more? Additional details regarding this position can be found in the position description.

Work Schedule and Additional Information:

• Full-time employment
• Work hours are 8:00 AM to 4:30 PM, Monday - Friday, with a 60-minute lunch.

Telework: You may have the opportunity to work from home (telework) part-time, up to 3 days per week.

In order to telework, you must have a securely configured high-speed internet connection and work from an approved location inside Pennsylvania.

If you are unable to telework, you will have the option to report to the headquarters office in Harrisburg. The ability to telework is subject to change at any time.

Additional details may be provided during the interview.

• Salary: In some cases, the starting salary may be non-negotiable.
• You will receive further communication regarding this position via email. Check your email, including spam/junk folders, for these notices.

Qualifications

QUALIFICATIONS

Minimum Experience and Training Requirements:

• A bachelor’s degree in health, social or behavioral sciences, statistics, or a related field; or
• An equivalent combination of experience and training.
• Applicants will be considered to have met the educational requirements once they are within 3 months of graduating with a qualifying degree.

Other Requirements:

• You must meet the PA residency requirement. For more information on ways to meet PA residency requirements, follow the link and click on Residency Guidelines.
• You must be able to perform essential job functions.

How to Apply:

Resumes, cover letters, and similar documents will not be reviewed, and the information contained therein will not be considered for the purposes of determining your eligibility for the position.

Information to support your eligibility for the position must be provided on the application (i.e., relevant, detailed experience/education).

If you are claiming education in your answers to the supplemental application questions, you must attach a copy of your college transcripts for your claim to be accepted toward meeting the minimum requirements. Unofficial transcripts are acceptable.

Your application must be submitted by the posting closing date. Late applications and other required materials will not be accepted.

Failure to comply with the above application requirements may eliminate you from consideration for this position.

All application materials and interview responses must reflect the applicant’s own experience, qualifications, and work. Applicants may use generative AI tools for preparation purposes only.

Use of AI to misrepresent or falsify information, or to assist during interviews, is not permitted. Review the Guidance for Generative AI Tools & Job Seekers for additional information.

Veterans:

• Pennsylvania law (51 Pa. C.S. §7103) provides employment preference for qualified veterans for appointment to many state and local government jobs. To learn more about employment preferences for veterans, go to www.pa.gov/agencies/employment/how-to-apply.html and click on Veterans.

Telecommunications Relay Service (TRS):

• 711 (hearing and speech disabilities or other individuals).

If you are contacted for an interview and need accommodations due to a disability, please discuss your request for accommodations with the interviewer in advance of your interview date.

The Commonwealth is an equal employment opportunity employer and is committed to a diverse workforce.

The Commonwealth values inclusion as we seek to recruit, develop, and retain the most qualified people to serve the citizens of Pennsylvania.

The Commonwealth does not discriminate on the basis of race, color, religious creed, ancestry, union membership, age, gender, sexual orientation, gender identity or expression, national origin, AIDS or HIV status, disability, or any other categories protected by applicable federal or state law.

All diverse candidates are encouraged to apply.

Additional Information

• Completing the application, including all supplemental questions, serves as your exam for this position. No additional exam is required at a test center (also referred to as a written exam).
• Your score is based on the detailed information you provide on your application and in response to the supplemental questions.
• Your score is valid for this specific posting only.
• You must provide complete and accurate information or:
  • your score may be lower than deserved.
  • you may be disqualified.
• You may only apply/test once for this posting.
• Your results will be provided via email.