Enrollment Broker Operations Division MA II

Texas Health & Human Services Commission•Austin, TX

53d•Remote

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 Management Analyst 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 division of Program Enrollment and Support is responsible for ensuring contract requirements are met, identifying performance trends, and evaluating improvement activities or contract remedies. The Management Analyst II position involves significant amount of planning, developing, coordinating, and implementing agency programs and providing consultative services and technical assistance from the Enrollment Broker team, program staff, governmental agencies, community organizations, or the general public. Ensures compliance with agency policies and standards, processes, and procedures. Manages cross-division collaboration to ensure horizontal and vertical communication, appropriate project prioritization, and effective resource utilization. A key component of the Management Analyst II position is to provide support for designated vendor activities and this position is responsible for identifying problems and developing potential solutions to operational issues. Serves as the subject matter expert in assigned workgroups and other contract activities with respect to the Enrollment Broker scope of work. Works directly with the vendor to coordinate, develop, document, and review processes and changes. Monitors activities for contract compliance, utilization targets, provides timely responses to information requests, resolution of issues, consultative and technical assistance, and documentation to ensure adherence to performance requirements. 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. This position reports to the Director II of Enrollment Broker Operations and works under limited supervision, with considerable latitude for the use of initiative and independent judgment

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.
Skill in using personal computer application software such as Microsoft Word, Power Point, Excel, Microsoft Project or similar programs.
Skill in written and oral communication.
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 prioritize workload.
Ability to work cooperatively as a team member in a rapid-paced, deadline-oriented environment.
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.

Responsibilities

Oversees and participates in program planning, development, and implementation.
Develops tools and techniques for project management.
Coordinates, leads, and facilitates project meetings with stakeholders.
Organizes project records, including project documentation and open issue resolution lists.
Maintains records of reported errors and project deficiencies including those noted through direct oversight or reported by state users.
Submits and analyzes weekly status reports, gives updates to management and peers on the status of projects.
Monitors activities for contract compliance and utilization targets.
Ensures proper documentation requirements regarding adherence to key performance requirements are met.
Provides timely responses to information requests.
Serves as a consultative and technical resource for Enrollment Broker scope of work.
Reviews, monitors, tracks reports and deliverables, and notifies the Contract Manager when vendor is out of compliance with established performance measures.
Prepares administrative reports, and specialized research projects.
Provides professional communications to Medicaid and CHIP health plans, the Enrollment Broker, HHSC staff, other state agencies and external associations on managed care and Enrollment Broker operations.
Evaluates the health and dental plan's ability to successfully ingest and produce the required enrollment data on the monthly and daily files defined in the Joint Interface Plan (JIP) by performing Operational or Readiness reviews.
Conducts detailed, complex research and analysis of operational issues including examination of rules, and policies.
Assist in planning and conducting operational and readiness reviews for Medicaid Managed Care, CHIP enrollment, and Medicaid 1115 waiver programs, or LTSS to analyze business requirements and to support system and operational processes.
Ensure to provide helpful feedback between the state, enrollment broker, and health and dental plans to meet the contractual requirements on operational and readiness reviews.

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.

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