Manager V

TX-HHSC-DSHS-DFPS•Wichita Falls, TX

3d•$6,378 - $10,786•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 Program Support Manager is responsible for performing highly advanced managerial work for the daily operations of the HHSC Program Support Unit staff/functions for managed care programs and other program support functions for managed care activities at HHSC. This manager is also responsible for planning, implementation, coordination, monitoring, and evaluation of policies and procedures, monitors compliance with policies and procedures, and applies this function to existing programs, as well as newly implemented programs. This position will hire, train, and supervise the activities and staff related to supporting the program support functions for Medicaid managed care across the state. This position will develop, implement, and oversee processes and staff responsibilities related to critical managed care individual and member activities across the state. This position will provide technical guidance for state employees and contracted managed care organization staff. The manager will represent the section and the agency at meetings, hearings, trials, conferences, committees, and panels. This position works under minimal supervision and requires extensive initiative, self-direction, and independent judgment. The Program Support Unit consists of units in all managed care service delivery areas and is responsible for critical support and coordination of multiple aspects of STAR+PLUS and STAR Kids, as well as other managed care programs and services. This position will support units across the state of Texas. This section serves as the primary contact for individual and member transitions in and out of the STAR+PLUS service areas and for communication between the state, managed care organizations and other contractors. This section coordinates continuity of care for members that are suspended or dis-enrolled from managed care, transfer/move within the state, and to a different state program. This section also assists in the Promoting Independence initiative and assists individuals who "age out" of various state programs.

Requirements

Knowledge of Medicaid managed care programs policy and processes with focus on transitions in and out of the STAR+PLUS and STAR Kids service areas including continuity of care for members that are suspended or dis-enrolled from managed care, transfer/move within the state, to a different state program, and assists individuals with placement on state program interest lists.
Mandatory experience in direct support of a Medicaid program including experience communicating with managed care organizations and member families.
Knowledge of local, state, and federal laws related to the program area; of public administration and management techniques; of research techniques; of training techniques; and of program management processes and techniques.
Skill in identifying measures or indicators of program performance and in operating computers and applicable software.
Ability to evaluate the impact policy and program changes may have on program support unit activities.
Ability to manage projects and workgroups to facilitate the implementation of required program support unit changes.
Ability to gather, assemble, correlate, and analyze facts and to work with staff to devise solutions to problems, market programs, prepare reports, to develop, evaluate, and interpret policies and procedures, to communicate effectively, and to train, lead, assign, and prioritize staff workloads.
Ability to coordinate with other areas of HHSC to represent the Program Support Unit. Candidate will function as a manager for the Program Support Unit.
Ability to coordinate team member actions operating in direct support of the Medicaid managed care programs and is responsible for resolving Medicaid Program Enrollment & Support issues.
Ability to coordinate managed care program support unit activities with STAR PLUS waiver services staff.
Experience in a field related to Program Support Unit service activities.
Required minimum of three years of full-time management experience.
Required experience working professionally with a broad range of stakeholders.
Required experience planning, assigning, and directing the work of others.

Responsibilities

Manages Program Support Unit (PSU) regional staff activities. Oversees the performance of a variety of required Medicaid STAR+PLUS and STAR Kids program technical, training, research, planning, policy, program assessment, and administrative activities.
Coordinates PSU staff who act as program enrollment liaisons with managed care organizations, internal program staff, and Medicaid member families to explain program enrollment requirements.
Oversees PSU policy analysis, project implementation, and policy documentation.
Plans, assigns, and supervises the work of assigned PSU staff.
Directs and approves PSU staff activities to meet program objectives: give guidance and direction/assistance to PSU staff developing and implementing STAR+PLUS and STAR Kids PSU program's policies, procedures, rules and guidelines; reviewing and approving PSU implementation of policies, procedures, rules and guidelines to enroll Medicaid members in managed care; reviewing PSU issue status information and to report progress towards meeting PSU program goals; reviews and approves PSU team management, area fiscal and productivity reports; PSU staffing forecasts, and programmatic and fiscal needs of the program.
Manages the collection, organization, analysis, and preparation of PSU member enrollment materials in response to program information requests.
Implements and provides management support of PSU program policies, procedures, manuals, and standards and planned program activities.
Coordinates the development and implementation of effective PSU Medicaid member enrollment techniques for evaluating STAR+PLUS and STAR Kids efficiencies, identifies the need for new or modified managed care programs, and guides PSU staff in the development and integration of new Medicaid managed care enrollment methods and procedures.
Directs the completion and monitors required PSU regional staff administrative and performance reports, studies and specialized managed care enrollment projects.
Coordinates compliance with PSU, STAR+PLUS, and STAR Kids program policies and procedures, statutes, and rules and takes corrective action(s) with PSU staff and managed care organizations as needed.
Manages PSU operational problem analyses and required PSU operational report preparation.
Identify PSU regional staff managed care member enrollment process and procedure issues and resolves operational problems.
Assigns and manages PSU staff specialized research projects.
Delivers technical assistance related to planning, implementing, and monitoring of ongoing PSU managed care member enrollment programs and services.
Consults with public and private entities involved in STAR+PLUS and STAR Kids program and other managed care programs to resolve member enrollment problems, identify PSU staff training needs, and discuss PSU program effectiveness.
Provides guidance to PSU regional staff in the development and integration of new internal methods and procedures.
Works within agency constraints to provide PSU regional staff with tools needed to carry out their member enrollment responsibilities.
Represents PSU regional staff and HHSC at meetings, hearings, trials, conferences, committees, and panels.