Medicare Outreach Program Specialist

Department: Pennsylvania Department of Aging
Division: Quality and Compliance
Work Arrangement: Home-Based / Field-Based
Headquarters: South Central Region
Primary Coverage Area: Blair, Mifflin, Juniata, Perry, Union, Snyder, Northumberland, Columbia, or Montour County
Schedule: Monday–Friday, 8:00 AM–4:30 PM
Hours: 37.5 hours per week
Travel: Frequent regional travel required; statewide and occasional overnight travel may be necessary

Medicare Outreach Program Specialist Position Overview

The Pennsylvania Department of Aging is seeking a Medicare Outreach Program Specialist to support quality assurance, compliance monitoring, and program improvement across Pennsylvania's aging-services network.

This position serves as a liaison between the Pennsylvania Department of Aging and Area Agencies on Aging (AAAs), helping ensure that aging programs and services are administered in accordance with applicable policies, procedures, program standards, and quality requirements.

The Program Specialist will conduct onsite and remote monitoring, review program operations and documentation, identify areas for improvement, prepare detailed reports, provide technical assistance, and follow up on corrective and performance improvement activities.

This is a home-based position with significant field travel throughout the assigned geographic area. The successful candidate must be comfortable working independently, interacting with government agencies and community partners, reviewing complex information, and presenting findings to both small and large groups.

Medicare Outreach Program Specialist Key Responsibilities

• Conduct onsite and offsite monitoring of aging programs and services within an assigned geographic region.

• Travel frequently throughout the assigned area and, when necessary, statewide, including occasional overnight travel.

• Serve as a liaison between the Pennsylvania Department of Aging, Area Agencies on Aging, service providers, consumers, families, and other public entities.

• Review program operations, records, data, policies, and procedures to evaluate compliance and quality.

• Identify deficiencies, risks, and opportunities for program improvement.

• Prepare comprehensive written reports documenting monitoring activities, findings, recommendations, and follow-up requirements.

• Assist Area Agencies on Aging with Performance Improvement Plans (PIPs) and monitor progress toward corrective actions.

• Provide technical assistance and consultation regarding quality assurance, program requirements, policies, and procedures.

• Maintain working knowledge of Pennsylvania Department of Aging programs, services, policies, and procedures.

• Interpret and explain aging-services policies and procedures to internal and external stakeholders.

• Use WellSky/A&D and other program-specific information systems to support monitoring and reporting activities.

• Analyze written materials, data, and individual cases for compliance and acceptable program practices.

• Review and comment on program and policy statements as requested.

• Participate in committees, workgroups, task forces, and special projects.

• Assist with the development of educational and training materials.

• Prepare and deliver formal presentations to Area Agencies on Aging, state agencies, community partners, and other stakeholders.

• Communicate program objectives, policies, findings, and recommendations clearly in both written and verbal formats.

• Work collaboratively with county and state personnel and external partners.

• Manage multiple assignments independently while meeting established deadlines.

• Perform other duties and special projects as assigned.

Medicare Outreach Program Specialist Minimum Qualifications

• Bachelor's degree.

• At least two years of professional experience conducting human-services research, program work, quality assurance, or providing social/human services to clients.

• Knowledge or experience with quality assurance and risk-management principles.

• Working knowledge of home- and community-based services or other human-services programs.

• Strong written and verbal communication skills.

• Strong Microsoft Office skills, including Word, Excel, and related applications.

• Ability to analyze information, identify issues, and develop comprehensive written reports.

• Ability to interpret policies, regulations, procedures, and program requirements.

• Ability to work independently with minimal supervision.

• Ability to work effectively with government agencies, community organizations, service providers, consumers, and families.

Medicare Outreach Program Specialist Preferred Experience

Experience in one or more of the following areas is highly desirable:

• Aging services

• Medicare or Medicaid programs

• Home and community-based services (HCBS)

• Human-services program administration

• Quality assurance or quality improvement

• Compliance monitoring

• Program auditing or program evaluation

• Case management

• Healthcare or social-services compliance

• Long-term care

• Government or public-sector programs

• Regulatory monitoring

• Performance improvement plans and corrective actions

Skills & Abilities

The successful candidate will demonstrate:

• Excellent written and verbal communication.

• Strong analytical and problem-solving abilities.

• Strong organizational and time-management skills.

• Ability to develop clear, comprehensive reports.

• Ability to interpret regulations, policies, and program directives.

• Strong interpersonal and relationship-building skills.

• Confidence presenting information to groups.

• Ability to manage changing priorities and multiple deadlines.

• Ability to work independently while knowing when to seek guidance.

• Proficiency with Microsoft Office and computer-based data systems.

• Willingness and ability to travel frequently and extensively, including occasional overnight travel.

Important Work Environment Information

This is a home-based position, but it is not a fully remote/no-travel position.

The employee will regularly travel to Area Agencies on Aging, service providers, and other locations for onsite monitoring, meetings, presentations, and program-related activities. Some locations may not be accessible by public transportation.

The employee must be available for both remote and onsite meetings and activities.

Ideal Candidate

The ideal candidate is a human-services or healthcare professional who has experience with program monitoring, quality assurance, compliance, case review, regulatory requirements, or program administration.

Someone who enjoys reviewing information, identifying issues, writing reports, working with community organizations, explaining requirements, and helping programs improve would be well suited for this position.

This is not a traditional Medicare sales or call-center position. The role focuses on quality, compliance, monitoring, program improvement, and coordination within Pennsylvania's aging-services system.