Enrollment Broker Operations Director

Texas Health & Human Services Commission•Austin, TX

56d•Hybrid

About The Position

The Texas Health and Human Services Commission (HHSC) Medicaid and CHIP Services (MCS) department seeks a highly qualified candidate to fill the Director II position in Program Enrollment and Support, Enrollment Broker Operations. MCS is driven by its mission to deliver quality, cost effective services to Texans. This position makes a significant contribution to MCS's mission by managing day-to-day operations and oversight of the Enrollment Broker (EB) vendor while coordinating EB system projects with HHSC eligibility system (TIERS) team, Managed Care Organizations, Texas Medicaid and Healthcare Partnership (TMHP), and other stakeholders as required. The Enrollment Broker Operations Director II performs highly advanced (senior level) managerial work of daily operations of Medicaid/CHIP Services, Program Enrollment & Support, Enrollment Broker Operations. This position has seven direct reports and manages day-to-day operations and oversight of the Enrollment Broker vendor. The Enrollment Broker Operations section is responsible for ensuring contract requirements are met, identifying performance trends, and evaluating improvement activities or contract remedies. Work involves managing and prioritizing staff assignments, developing, coordinating, and implementing major agency program (s), and providing consultative services and technical assistance to program staff, governmental agencies, community organizations, or the general public. This position directs the development of policies, guidelines, procedures, and communication with respect to Medicaid & CHIP managed care operations. Manages compliance and significant project coordination with the Health and Human Services (HHS) enterprise programs and stakeholders. Develops improvement plans with stakeholders and contractors for identified deficiencies. Ensures staff and vendor compliance with agency policy and unit standards, processes, and procedures. Manages cross-division collaboration to ensure horizontal and vertical communication on projects and initiatives, appropriate project prioritization, and effective resource utilization. Works under minimal supervision, with extensive latitude for the use of initiative and independent judgment. The ideal candidate thrives in an environment that emphasizes critical thinking and problem solving, teamwork to achieve goals, integrity, excellence through high professional standards and personal accountability, and curiosity to continuously grow and learn.

Requirements

Knowledge of Medicaid and CHIP managed care enrollment policy and processes.
Local, state, and federal laws related to the program area; of public administration and management techniques; of statistical analysis processes; of budget processes; of research techniques; of training and marketing techniques; and of program management processes and techniques.
Skill in Identifying measures or indicators of program performance and in operating computers and applicable software.
Coordinating with multiple stakeholders.
Coordinating team member actions operating in direct support of the enrollment broker activities and team members responsible for resolving Medicaid and CHIP eligibility and managed care enrollment issues.
Ability to Evaluate impacts that policy and program changes may have on Medicaid and CHIP managed care enrollment.
Manage projects and work groups to facilitate the implementation of changes to managed care enrollment.
Review enrollment broker contract deliverables.
Gather, assemble, correlate, and analyze facts; to devise solutions to problems; to market programs; to prepare reports; to develop, evaluate, and interpret policies and procedures; to communicate effectively; and
Train, lead, assign, and prioritize staff workloads.
At least two years' experience in Medicaid and CHIP policy and procedures.
Bachelor's degree from an accredited college or university.
Educational requirements are transferable with relevant work experience on a year-for-year basis.
Past experience working in a leadership role which may include, but is not limited to managing staff, overseeing work products, and developing long-range and short-term plans.

Responsibilities

Directs and approves Enrollment Broker Operations staff activities to meet the goals and objectives of the program including but not limited to: providing guidance and directional assistance to staff charged with developing and implementing the program's policies, procedures, rules and guidelines affecting the overall functioning of the program; reviewing and approving the implementation of policies, procedures, rules and guidelines deemed appropriate for the administration of the program; reviewing and approving the use of evaluation tools designed by program staff to determine/measure the progress towards meeting the goals and objectives of the program; reviews and approves management, fiscal and productivity reports; forecast staffing, physical, programmatic and fiscal needs of the program. Directs all evaluation activities of the program (internal, external and contractor evaluation); provides updates to executive staff.
Manages the collection, organization, analysis, and preparations of materials in response to request for program information and reports. Establishes strategic goals by gathering pertinent business and operations information; identifying and evaluating trends and options; choosing acourse of action; defining objectives; evaluating outcomes for the program. Establishes the program's goals and objectives to support the development of strategic plans and program priorities including but not limited to: utilizing the results of and as necessary conducting special studies and/or research to identify methods/processes/procedure having a positive and negative effect on the program to determine area of the program requiring change to ensure the overall efficient functioning of the program; developing and implementing techniques for evaluating policies, process and procedures and devising solutions to achieve program improvement. Reviews overall business operations of the program to ensure program efficiency and effectiveness for the program staff, contractors, and users of the program services. Reorganizes/ restructures the program as necessary to meet program goals and operational functioning.
Manages the development and implementation of program processes and tools for use by staff to determine if contractors are meeting their contract performance obligations and directing staff toward identifying trends or anomalies that may require additional oversight and monitoring. Oversees on-site and desk reviews of the enrollment broker.
Manages program communications and reports to external and internal parties regarding performance management issues, activities or results. Prepares status reports for management identifying progress, productivity, key milestones, results of evaluation activities, overall performance of contractor, trends or anomalies that may require additional contract oversight and action.
Provides technical guidance to the division and department staff related to performance management and monitoring. Coordinates surveys and reviews to determine compliance with certification requirements, laws, regulations, policies, and procedures.
Hires, manages and develops staff, and recommends appropriate personnel actions to foster a fair, honest and equitable work environment Provides direct reports with work assignments, clear direction and information on responsibilities and work performance expectations, Develops work performance plans and conducts performance evaluations at least annually. Keeps direct reports Informed about relevant departmental activities and decisions. Provides staff with tools and information needed to carry out their responsibilities and to succeed in their work. Reviews and approves leave and carries out other expected human resources activities with direct reports.

Benefits

comprehensive benefits package includes 100% paid employee health insurance for full-time eligible employees
defined benefit pension plan
generous time off benefits
numerous opportunities for career advancement

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