HEALTH SYSTEMS SPECIALIST 1 DEFINITION:
Under direction of the Chief, Health Systems Review Program, Department of Health and Senior Services, is responsible for supervision of a team of Health Systems Specialists of lower grades involved in design, development, and delivery of specialized health services, sophisticated medical technologies, and health care facilities; supervises preparation of health service and medical facilities= plans in a group of specifically assigned areas; supervises preparation and monitoring of state regulations, technical analysis of Certificate of Need applications, and long range plans; does other related duties as required.
NOTE: The examples of work for this title are for illustrative purposes only. A particular position using this title may not perform all duties listed in this job specification. Conversely, all duties performed on the job may not be listed.
EXAMPLES OF WORK:
Assigns and supervises staff in the research of health, financial, and legislative dimensions of health delivery systems and development/implementation of plans/policies to improve efficiency of these services in a manner which will result in cost savings to the payer of those services, particularly the State of New Jersey.
Supervises staff in the review, analysis, and reporting of health and cost impacts on NJ of actual and proposed federal/state programs, legislation, and/or activities planned and proposed by public/private institutions and agencies; formulates research designs to be followed by staff development of these reports.
Supervises staff in the provision of technical assistance to New Jersey=s five area wide health systems agencies, other state departments, private/public hospitals, professional organizations, and long term care facilities in conducting health and health cost analysis and in designing plans for provision of health services.
Supervises staff in basic research and development of standards/criteria for reviewing Certificate of Need applications seeking state approval to construct or expand new health care facilities or introduce/modify health care services and provide technical expertise to the Director in negotiations with the statewide Health Coordinating Council and NJ Health Care Administration Board in the revision/passage of these standards/criteria.
Supervises staff in the review of Certificate of Need applications, hospital and other health facilities long-range plans, and in development of health services policies, rules, and regulations.
Ensures that staff researching/analyzing impact on NJ of proposed federal/state legislation and regulations evaluates and reports findings to the Chief Health Systems Review Program.
Manages work operations and/or functional programs, and has responsibility for employee evaluations and for effectively recommending the hiring, firing, promoting, demoting, and/or disciplining of employees.
Provides technical assistance to the Director, Health Systems Services in preparation for administrative hearings, litigations, and promulgation of regulations; testifies at administrative hearings and judicial proceedings as a representative of the department.
Prepares and supervises preparation of research reports, analytical studies, and recommendations for design/delivery of specific health services.
Performs and supervises performance of technical analysis of demographic, utilization, cost, mortality, morbidity, and facility data. Formulates recommendations for department policy in specific assigned areas of health care facilities, services, and medical technologies.
Staffs Commissioner advisory committees as assigned.
Develops working relationships with regional health systems agencies and major institutional providers.
Provides technical assistance to other department units, other state departments, institutional health providers, community and professional organizations on matters related to system/service design and medical facilities development.
Makes public presentations of research findings.
Recommends new state policies/regulations and amendments to existing policy/regulations.
Prepares complex/technical correspondence in the course of official duties.
Makes recommendations concerning appropriate guidelines for development of hospital and long term care facility capital and service plans, and reviews plans submitted by major institutional providers.
Prepares monthly progress reports.
Provides technical content reviews for Certificate of Need approval/denial letter.
Keeps current with state/federal regulations, policies, and guidelines in the medical areas assigned.
Will be required to learn to utilize various types of electronic and/or manual recording and information systems used by the agency, office, or related units.
REQUIREMENTS:
NOTE: Applicants must meet one of the following or a combination of both experience and education. Thirty (30) semester hour credits are equal to one (1) year of relevant experience.
Nine (9) years of professional experience in a government or private health organization in which primary job responsibilities included health care research, health systems design, health policy development, or health law.
OR
Possession of a bachelor's degree from an accredited college or university; and five (5) years of the above-mentioned professional experience.
OR
Possession of a J.D., LL.B., or Master's degree in Public Health, Public Administration, Hospital or Health Services Administration, Medical Care Administration, Social Work-Policy, Sociology, City/Urban/Regional Planning, Economics, Nursing, Nursing Administration, or related fields; and four (4) years of the above indicated professional experience.
OR
A Doctorate in any of the above fields; and three (3) years of the above indicated professional experience.
NOTE:"Professional experience" refers to work that is creative, analytical, evaluative, and interpretive; requires a range and depth of specialized knowledge of the profession's principles, concepts, theories, and practices; and is performed with the authority to act according to one's own judgment and make accurate and informed decisions.
LICENSE:
Appointees will be required to possess a driver's license valid in New Jersey only if the operation of a vehicle, rather than employee mobility, is necessary to perform the essential duties of the position.
KNOWLEDGE AND ABILITIES:
Knowledge of social/economic/cultural determinants of human health affecting distribution of illness, exposure to health risks, patterns of behavioral disorders, and problems associated with access to health services by selected populations.
Knowledge of social research design and applied social statistics including sampling methodologies, construction of social survey instruments, and application/interpretation of statistics and content analysis in social/health research.
Knowledge of regional approaches to development/implementation of public policy/plans as well as organizational, legal, social, economic, geographic, and transportation factors influencing effective delivery of health services on a regional basis.
Knowledge of health systems principles/procedures including theory and methodology, decision-theory, administration theory, and organizational theory/practice.
Knowledge of health systems design including organization, capital and operational costs, and reimbursement policies influencing design/development of specialized health care facilities/services.
Knowledge of the organization/operation of health care facilities/services such as hospitals, long term care facilities, clinics, special hospitals, HMOs, group medical practices, and public health centers.
Knowledge of policies/practices of major third party payers.
Knowledge of organized programs for provision of health services such as Medicare, Medicaid, Blue Cross/Blue Shield, HMOs and federal categorical programs.
Knowledge of the effectiveness of various organizational models/interventions in providing health services and promoting health of populations with specific social/medical characteristics.
Knowledge of current medical technologies, their costs, applications, clinical benefits, and factors related to their efficient delivery.
Knowledge of capital finance including budgeting, financial management, and operational costs associated with investments.
Ability to interpret regulatory requirements.
Ability to perform technical reviews of Certificate of Need applications for facilities, specialized health services, and medical technologies, and to interpret/apply technical standards.
Ability to research/develop recommendations concerning capital/operational costs, utilization factors, staffing complements, access features, and their regional scope in delivery of specialized medical services and technologies.
Ability to prepare recommendations in the form of proposed policy and/or proposed state regulations for review.
Ability to review, interpret, and analyze impact of new legislation/regulations on costs, access to, and delivery of health services within the state.
Ability to organize, prepare, and deliver speeches to professional and community groups, organizations, and societies.
Ability to perform complex/technical assignments independent of close supervision and to ensure that they are completed on schedule.
Ability to supervise interns in conduct of research studies.
Ability to write clear/concise reports of research findings that are technically accurate.
Ability to prepare technical analysis of specific denials under appeal and to represent the department as a technical witness in the course of administrative hearings and litigations.
Ability to prepare technical correspondence.
Ability to maintain program records and files.
Ability to utilize various types of electronic and/or manual recording and information systems used by the agency, office, or related units.
Ability to read, write, speak, understand, and communicate in English sufficiently to perform duties of this position. American Sign Language or Braille may also be considered as acceptable forms of communication.
Persons with mental or physical disabilities are eligible as long as they can perform essential functions of the job after reasonable accommodation is made to their known limitations. If the accommodation cannot be made because it would cause the employer undue hardship, such persons may not be eligible.
CODES: 29/R29 - 00286 RKR/cah 5/9/98
