HCBS Compliance Analyst

TX-HHSC-DSHS-DFPS•Austin, TX

8d•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 and CHIP Services (MCS) division seek a highly qualified candidate to fill the position of Compliance Analyst IV. The Compliance Analyst reports to the Home and Community-Based Services (HCBS) Quality Manager of the Quality Reporting Unit and works within the Quality Data Analytics and Reporting Department. The Compliance Analyst performs highly complex (senior-level) compliance analysis work involving interpreting, monitoring, and reporting on adherence to applicable federal, state, and local laws and regulations around Home and Community-based Services. The Compliance Analyst works under limited supervision, with considerable latitude for the use of initiative and independent judgment. 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 using data-driven evidence-based approaches to hold Medicaid and CHIP service providers and Managed Care Organizations accountable, ensure access to high-quality care, and drive quality-based innovation. 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.

Requirements

Knowledge of:• Relevant federal and state rules and regulations related to Medicaid, Home and Community-Based Services, or long-term services and supports.
Knowledge of:• Contract and compliance monitoring.
Knowledge of:• Statistical concepts, sampling methods, and models.
Skill in:• Conducting data searches and evaluating large amounts of data.
Skill in:• Using applicable data visualization software to communicate compliance summaries and recommendations.
Skill in:• Preparing concise and accurate reports for agency management and staff.
Skill in:• Preparing and presenting reports for agency management and other staff.
Ability to:• Identify problems, evaluate alternatives, and implement effective solutions.
Ability to:• Maintain effective working relationships and communicate effectively with other teams and departments.
Ability to:• Oversee and/or supervise the work of others.
Graduation from an accredited four-year college or university required; major coursework in public health, public administration, research methodology, psychology, or a related field preferred.
Experience with Medicaid waiver programs, Home and Community-Based Services, long-term services and supports, or healthcare quality.
Experience interpreting data related to Medicaid, Home and Community-Based Services, or long-term services and supports.

Responsibilities

Reviews HCBS data and forms from various sources to determine state compliance with technical specifications and state and federal laws, rules, and regulations related to long-term care services and supports.
Develops accurate reports and visual summaries to communicate audit results and makes recommendations on improving HCBS outcomes and compliance across the state.
Performs advanced auditing work of HCBS records. Creates compliance review and audit guidelines. Trains internal and external stakeholders on the audit process.
Develops timelines and defines the scope of compliance review work. Reviews contracts and other legal documents related to compliance reviews.
Submits reporting results and findings as part of the HCBS Quality Measure Set reporting to the Centers for Medicare and Medicaid Services (CMS) in accordance with CMS-2442-F requirements. Presents reporting results to internal and external stakeholders.
Performs related work as assigned.