Contract Specialist IV

TX-HHSC-DSHS-DFPS•Houston, TX

9d•Hybrid

About The Position

Join the Texas Health and Human Services Commission (HHSC) and be part of a team committed to creating a positive impact in the lives of fellow Texans. At HHSC, your contributions matter, and we support you at each stage of your life and work journey. 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. Explore more details on the Benefits of Working at HHS webpage. 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 within the newly created Long Term Care - Facility Fiscal Monitoring (LTC FFM) team in Provider Monitoring. 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 provider and fiscal contract monitoring reviews for Nursing Facilities, Hospice providers, and Intermediate Care Facilities for Individuals with an Intellectual Disability (ICF/IID). 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 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. May serve as a Contract Manager. Completion of work requires initiating and implementing new methods and/or techniques for monitoring activity or reviews. May train others. During the first year, the position will assist in building the team’s foundation, which includes developing procedures, monitoring tools, and performance measures; coordinating with internal and external stakeholders; and establishing the operational framework for ongoing fiscal monitoring activities. This position reports to the LTC FFM Manager within the Contract Administration and Provider Monitoring (CAPM) Unit but may assist with program and fiscal contract monitoring reviews for the Community Living Assistance and Support Services (CLASS), Deaf-Blind with Multiple Disabilities (DBMD), Home and Community-based Services (HCS), Texas Home Living (TXHML) Medicaid Waiver programs, Consumer Directed Services (CDS), and Community First Choice (CFC).

Requirements

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.
At least 1 year of experience in conducting auditing, financial oversight, fiscal compliance monitoring, or other types of relevant oversight activities within the past 3 years, required.
Experience developing and implementing policies and procedures, required.
Experience using MS Excel, Word, and PowerPoint, required.
Ability to travel at least 50% of the time with some travel including overnight stays, as stated in the state application, required.
To maintain employment as a Contract Specialist IV, 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 driver’s license.
Knowledge of: local, state, and federal laws related to Medicaid Waiver Programs and LTC facility-based programs; of public administration and management techniques; of statistical analysis processes; of research techniques; of program planning and implementation; of administrative and management techniques; of project management practices, procedures and implementation.
Skill in: formulating written communication for various audiences; managing cross-organizational projects; managing competing priorities using personal computing devices; data analysis, report development, and use of performance metrics to drive outcomes. Intermediate skills in operating a computer and applicable software, specifically Excel, SharePoint, PowerPoint and Word.
Ability to: analyze, synthesize and summarize proposed changes to state laws, program rules and regulations; gather, assemble, and correlate facts; make decisions and devise solutions to problems and to provide leadership and staff advice; express oneself clearly orally and to write or compile concise strategic or operational reports, legislative reports, studies and presentations, as needed; write and evaluate procedures; support the work of others; work with diverse groups, stakeholders, agency departments and leaders.

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.

Responsibilities

Prepares, leads and conducts monitoring reviews of contracted 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.
Assists in preparing justifications for the implementation of procedural or policy changes.
Assists in the review of Medicaid fee-for-service facility based providers and Waiver Programs 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 billing and develops corrective action plans to be implemented by providers.
May recommend and coordinate activities to produce more effective programs.
Acts as liaison with consumers, agencies and internal program staff to explain and provide technical assistance on agency and program statutory requirements.
Collaborates on analysis and documentation of program policies.
Provides technical assistance and training by telephone and in person to providers regarding the program requirements and Texas Administrative Code to facilitate compliance with contract requirements.
Prepares justifications for procedural changes pertaining to Medicaid fee-for-service programs.
Prepares administrative reports, studies, and specialized research projects.
Assumes a lead role for high level projects designated by the manager, mentors and trains other staff, and assists with responses to legislative inquiries.
Works collaboratively across MCS to identify innovative and effective solutions for clients and staff.
Effectively communicates with internal and external stakeholders regarding provider recoupments.
Determines eligibility for payment/installment plans and prepares overpayment letters and settlement agreements.
Decisions are varied but based on broad principles and guidelines.
May train others.
Performs related work as assigned.
Produces high quality products within timeframes specified by supervisor.
Identify and request training appropriate to job functions, as needed for LTC FFM.
May develop policy and procedure manuals