Contract Specialist IV

TX-HHSC-DSHS-DFPS • New Braunfels, TX

9d • Hybrid

About The Position

The Texas Health and Human Services Commission (HHSC) Medicaid CHIP Services (MCS) department seeks a highly qualified candidate to fill the position of Contract Specialist IV. MCS is driven by its mission to deliver quality, cost-effective services to Texans. The ideal candidate thrives in an environment that emphasizes: teamwork to achieve goals, excellence through high professional standards and personal accountability, curiosity to continuously grow and learn, critical thinking for effective execution, and integrity to do things right even when what is right is not easy. This position makes a significant contribution to MCS’s mission by performing program and fiscal contract monitoring reviews for Medicaid Waiver Programs such as the Community Living Assistance and Support Services (CLASS) and Deaf-Blind with Multiple Disabilities (DBMD), and for the Program for All-Inclusive Care for the Elderly (PACE) providers. This position performs advanced (senior-level) consultative services and technical assistance services to HHSC program and contract management staff, program providers, contractors, consumers, family members and guardians, and advocates. The position conducts, coordinates, and leads contract monitoring activity, special projects; provides technical assistance for the division; researches and analyzes highly complex projects or initiatives; prepares management responses and reports; performs highly advanced contract management work, involving the development and evaluation of a broad range of contracts. May plan, assign, and/or supervise the work of others. This position works under minimal supervision with extensive latitude for the use of initiative and independent judgment. Completion of work requires initiating and implementing new methods and/or techniques for monitoring activity or reviews. May train others. This position reports to the Manager of CLASS, DBMD, and PACE monitoring within the Contract Administration and Provider Monitoring (CAPM) Unit.

Requirements

• Knowledge in: local, state, and federal laws related to Medicaid Long Term Care waiver programs, and PACE.
• Knowledge in: CLASS and DBMD waiver programs.
• Knowledge in: public administration and management techniques.
• Knowledge in: statistical analysis processes and research techniques.
• Knowledge in: program planning and implementation.
• Knowledge in: technical assistance and administrative techniques.
• Knowledge in: project management practices and implementation.
• Skill in: formulating written communication for various audiences.
• Skill in: managing cross-organizational projects.
• Skill in: managing competing priorities using personal computing devices.
• Skill in: data analysis, report development, and use of performance metrics to drive outcomes.
• Skill in: operating a computer and applicable software, specifically Excel, SharePoint, PowerPoint, and Word, at an intermediate skill level.
• Ability to: analyze, synthesize and summarize proposed changes to state laws, program rules and regulations.
• Ability to: gather, assemble, and correlate facts.
• Ability to: make decisions and devise solutions to problems and provide leadership and staff advice.
• Ability to: express oneself clearly orally and write or compile concise strategic or operational reports, legislative reports, studies and presentations as needed.
• Ability to: write and evaluate procedures.
• Ability to: support the work of others.
• Ability to: work with diverse groups, stakeholders, agency departments and leaders.
• To maintain employment as a Contract Specialist, this position will require an applicant to obtain specialized certification as a Certified Texas Contract Manager (CTCM). If not currently a CTCM, the selected candidate must obtain CTCM certification within 12 months of hire date unless otherwise approved by supervisor and maintain certification throughout employment.
• Position requires a valid Texas driver’s license.
• Graduation from an accredited four-year college or university with major course work in a human service-related, business, or legal field, plus 4 years relevant work experience conducting auditing, compliance oversight, case management, or fiscal monitoring.
• Additional related monitoring and oversight experience may substitute for the required education on a year for year basis with a maximum substitution of four (4) years.
• Recent experience in conducting auditing, financial oversight, fiscal or contract compliance monitoring, or other types of relevant oversight activities, required.
• Intermediate skill level using MS Excel, Word, and PowerPoint, required.
• Ability to travel at least 50% of the time with some travel including overnight stays, required.

Nice To Haves

• Experience with 26 TAC Chapter 52 Community Services programs, and interpretation of an organization’s policies and procedures, guidelines, handbooks, laws, rules and/or statutes, preferred.
• QIDP, preferred.

Responsibilities

• Prepares, leads and conducts contract and fiscal compliance monitoring reviews of contracted CLASS, DBMD, and PACE providers to determine compliance with program guidelines, rules, laws and/or statutes.
• Works with program staff in determining trends and resolving technical problems.
• Responsible for completing sample selection and all other functions necessary for monitoring and review activity.
• Ensures any correspondence or forms are accurate and concise.
• Provides accurate information related to recovery of identified overpayments.
• Communicates effectively with internal and external stakeholders regarding provider correspondence items (Demand Letters, Payment Plans, etc.)
• Accurately evaluates providers’ eligibility for payment plans.
• Prepares written reports and tracks CLASS, DBMD, and PACE performance measurements.
• Provides tracking for all corrective action plans and recoupments including reporting and complies with HHSC’s and internal provisions of tracking, letters, and communications.
• Effectively communicates with internal and external stakeholders.
• Assists in preparing justifications for the implementation of procedural or policy changes.
• Assists in the review of CLASS, DBMD, and PACE program area functions and operations, in identification of areas of needed changes, and in the development of plans to improve or initiate programs or to address areas of concern.
• Assists in analyzing the business practices related to fiscal and contract compliance to develop corrective action.
• Develops and performs quality assurance oversight activities for the provider monitoring unit as assigned.
• Acts as liaison with individuals receiving services, agencies and internal program staff to explain and provide technical assistance on agency and program statutory requirements for CLASS, DBMD, and PACE.
• Collaborates on analysis and documentation of CLASS and DBMD program policies.
• Provides technical assistance and training via telephone and in person to CLASS, DBMD, and PACE providers regarding the billing guidelines and Texas Administrative Code to facilitate compliance with contract requirements.
• Prepares justifications for procedural changes pertaining to CLASS, DBMD, and PACE.
• Prepares administrative reports, studies, and specialized research projects.
• May recommend and coordinate activities to produce more effective CLASS, DBMD, and PACE programs.
• May develop policy and procedure manuals.
• Produces high quality products within timeframes specified by supervisor.
• Identify and request training appropriate to job functions, as needed.
• May train others.
• Performs related work as assigned.

Benefits

• Our comprehensive benefits package includes 100% paid employee health insurance for full-time eligible employees, a defined benefit pension plan, generous time off benefits, numerous opportunities for career advancement and more.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 1,001-5,000 employees