Medicaid Medical and Dental Benefits Policy Manager (Manager V)

TX-HHSC-DSHS-DFPS•Austin, TX

19h

About The Position

The Medical and Dental Benefit Policy (MDBP) Team within the Medicaid and CHIP Services (MCS) Office of Policy is seeking a manager who is passionate about improving critical services for fellow Texans. The Manager V position is responsible for overseeing a team that develops and updates the medical and dental benefits used in Texas Medicaid, one of the largest Medicaid programs in the country with annual budget of over $35 billion and a responsibility to provide services to over 4 million Texans. The top applicant will ensure the proper functioning of programs essential to the safety and independence of millions of children and adults in Texas that depend on vital services. The Medical and Dental Benefits Policy Manager reports to the Director of Medical and Dental Benefits Policy in the Office of Policy. This position performs highly advanced (senior-level) managerial work administering daily operations and activities related to the development of clinical policy for Medicaid medical benefits. The work conducted and overseen by this position is complex, technical, and requires high-level analytical skills and outstanding interpersonal skills. The position involves effective facilitation and negotiation within MDBP, with other areas within the Division, HHS, and the business operations, application maintenance and development, and claims administrator contractors, other vendors, and various external stakeholder groups. The position must be able to effectively synthesize evidence-based clinical information from a variety of sources (current practice, literature and evidence, other states, and federal and state guidance) when providing direction to staff. This position must have outstanding interpersonal skills and be able to effectively lead a team, as well as be a team player. The manager V works under the general direction of the Medical and Dental Benefits Policy Director with extensive latitude for the use of initiative and independent judgment.

Requirements

Knowledge of: How to research clinical, scholarly, academic, and peer-reviewed literature.
Effective leadership, motivational techniques, and best practices working with multiple stakeholders.
Healthcare systems and policy development
Skill in: Written and oral communication.
Making public presentations, writing technical information in an understandable organized format, and producing sophisticated research reports.
Managing competing priorities and establishing and maintaining effective working relationships.
Using personal computer application software such as Outlook, Teams, Microsoft Word, Power Point, Excel, and other similar programs.
Ability to: Effectively plan, assign, and supervise the work of others.
Clearly communicate and adhere to deadlines.
Communicate effectively by leading and motivating staff.
Apply a coaching management style to include active listening, asking questions, providing constructive/collaborative feedback, building trust, and setting SMART goals.
Engage with staff, addressing staff's needs, communications, individual styles, and work products in real-time, while using a supportive and even-handed approach.
Manage multiple staff at multiple levels of experience, backgrounds, and expertise while maintaining a positive attitude.
Evaluate and consider alternatives to issues to propose effective recommendations to leadership.
Work cooperatively and collaboratively as a team-member in a rapid-paced, deadline-oriented environment.
Lead project teams while working with multiple stakeholders to set clear goals, boundaries, and expectations across diverse groups and audiences.
Identify problems, assemble and analyze facts, to collaboratively and independently devise solutions to problems.
Exercise good judgment and work independently with minimum supervision.
A bachelor's degree or equivalent from an accredited university or college is required.
Experience and education may be substituted with each other on a year for year basis.
Supervisory, team-lead, or senior advisor experience.
Medicaid or other governmental healthcare or policy experience.

Nice To Haves

Master's degree in public health, nursing, health policy, biology, or other social/behavioral or health profession, or health-related field.
Experience working with Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) codes.
Clinical degree preferred but not required (e.g., Registered Nurse, Doctor of Nursing Practice, Occupational Therapist, Speech Language Pathologist, Licensed Clinical Social Worker, etc.).

Responsibilities

(30%) Plans, assigns, and supervises the work of staff in the development of clinical policy for Texas Medicaid medical benefits. Provides leadership and support to staff for the development of medical policy. Incorporates coaching, support, and appropriate delegation to ensure staff and office success. Oversight and leadership functions include tracking assigned tasks, meeting deadlines, identifying available resources for new assignments, and reviewing and approving all team’s work products. Organizes and develops materials such as research papers, summaries, and reports in response to requests for program and clinical information from providers, stakeholders, legislative or executive staff, and others.
(30%) Facilitates communication within the Office of Policy, Office of Medical Director, other MCS areas, and areas within HHS and other agencies. Assists with negotiations and problem-solving to ensure quality of work and that work is performed within time frames. Identifies areas of needed change and makes recommendations to improve operations. Remains solution oriented. Informs the Director of activities and emerging issues and proposes remedies.
(20%) Ensures staff are trained to complete assigned work. Motivates staff through positive and constructive feedback and communication related to work performance and communicating expectations. Motivates staff through positive and constructive feedback, fostering professional development, collaboration among and between teams, and promoting constructive interpersonal communication within their team. Assists staff in constructively dealing with change, as appropriate. Establishes goals and standards for the team and develops measurement tools for determining progress for meeting goals/standards, such as performance evaluations, progress plans, and spreadsheet tracking. Continuously works toward excellence, process improvement, and professional development of self and team. Performs human resource requirements including approval of time and leave, recruiting potential staff, interviewing, hiring, and advising staff.
(15%) Leads or participates in agency work groups as necessary for successful implementation of projects, policies, and initiatives. Works with and speaks to community and professional groups, other HHSC programs, other state agencies, legislative staff, and public stakeholders, to provide information, technical assistance, identify needs and resolve issues. Makes presentations and offers recommendations to executive staff. Reviews and approves staff responses to legislative, provider, and stakeholder requests for information.
(5%) Performs other duties as assigned to support the agency.