Director, Medicaid Provider Enrollment

TX-HHSC-DSHS-DFPS•Austin, TX

3d•$7,015 - $11,865•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 Director of the Provider Enrollment (PE) unit. Healthcare providers who want to participate in Texas Medicaid must enroll in the program and periodically revalidate their enrollment. The PE unit oversees the policies, operations, and systems that support the provider enrollment process. The PE Director is selected by and reports to the Director of the Provider Services within MCS Operations. The director performs advanced (senior-level) managerial work providing direction and guidance in strategic operations and planning including developing strategic plans and setting goals and objectives; developing policies, procedures, and guidelines for the PE unit. Responsibilities include interpreting state, federal and agency rules and policies as they apply to the program; technology planning and direction; approving PE program rules, policies and procedures; establishing and overseeing contract development and compliance; oversight of training plans; serving as a liaison between the department and other external and internal stakeholders such as provider associations, the Texas Legislature, and other state and federal entities; and monitoring overall program health. Oversees major technology and operational projects affecting PE. Represents the agency at conferences, panels and stakeholder meetings. Reports program and project status to agency leadership.

Requirements

Graduation from an accredited four-year college or university with a major in business administration or related field preferred.
At least 4 years of experience serving in a management capacity that includes supervising staff.
At least 4 years of experience working in Medicaid or related health services programs.
At least 4 years of experience with contracted vendor oversight.
Experience delivering technical and non-technical presentations to various audiences and stakeholders.
Experience responding to formal inquiries such as, legislative requests, audits, government open records requests, and executive correspondence.
Experience with information technology project delivery
State and federal Medicaid program rules and policies.
Policy development and analysis.
Contract administration, oversight and compliance.
Information technology systems, standards and practices.
Strong analytical, strategic conceptual thinking, planning, and execution.
Excellent verbal and written communication, capable of explaining complex information to a variety of stakeholders.
Conflict resolution, problem-solving, and making sound judgments under pressure.
Skill in written communications and presentations.
Provide leadership and strategic direction for the overall planning and coordination in support of organizational objectives.
Lead and manage teams through staff selection, staff development, and performance management.
Work collaboratively across the organization with diverse teams and stakeholders to accomplish objectives.
Balance team and individual responsibilities.
Manage complex operations involving people, information technology systems, and multiple vendor handoffs.
Build and maintain strong partnerships with internal and external stakeholders.
Continuously learn and adapt to new concepts and evolving business needs.

Nice To Haves

State and federal Medicaid provider enrollment processes preferred.
State government legislative processes preferred.

Responsibilities

Manages the day-to-day operational activities of direct reports and their assigned tasks.
Plans effective evaluation tools to determine and measure progress towards meeting the goals and objectives of the program.
Reviews management, fiscal, compliance and productivity reports to ensure operational goals are met.
Oversees the development of training plans and deliverables to meet current and new program activities and initiatives.
Reviews guidelines, procedures, rules, and regulations and monitors compliance.
Reviews results of internal audits or reviews to provide direction and guidance.
Provides overall direction to the PE program to improve organizational performance, efficiency and effectiveness based on strategic goals and objectives.
Evaluates the impact of proposed federal and state mandates on program objectives and plans short and long-term initiatives for compliance.
Assesses current and future program automation and compliance opportunities.
Evaluates agency priorities and other initiatives to identify dependencies and interagency impacts to PE initiatives.
Oversees and/or manages the successful implementation of technology and operational projects including development, management, and approval of project deliverables, resources, and status reports for internal and external use.
Assigns resources to projects as appropriate while managing competing priorities.
Identifies and monitors status of external projects that affect PE.
Represents the program by making presentations; providing information to executive leadership; collaborating with consumer and provider advocacy associations, managed care organizations, other areas of HHSC, HHSC contractors, and other state agencies and federal partners.
Responds to requests by legislators, auditors, attorneys, and other officials.
Coordinates with federal and state agencies to ensure program policies, standards and activities conform to federal and state requirements.
Manages and develops direct and indirect reports through development of performance standards, review of performance data, consultation, training and mentoring, and performance appraisals.
Promotes professional growth and development for staff.
Responsible for hiring and selection, assigning work, completing performance evaluations, recommending personnel disciplinary actions, and scheduling and approving leave.