Medicaid-Medicare Policy Advisor (PSVI)

TX-HHSC-DSHS-DFPS • Austin, TX

1d • Hybrid

About The Position

The Program Policy team within Medicaid and CHIP Services (MCS) Office of Policy is seeking a highly qualified candidate to fill Medicare-Medicaid Policy Advisor (Program Specialist VI). This position serves as the lead staff person in major Medicaid managed care projects, including the Texas Dual Eligible Integrated Care Program, state contracted Medicare Advantage Plans and Dual-eligible Special Needs Plans, and Medicaid wrap-around services for dually eligible beneficiaries. This position will also focus on enhancing Medicare-Medicaid integration for individuals dually eligible for both programs. This position works closely with internal and external stakeholders and will work with staff responsible for other Medicaid and Medicare programs and services. The position is expected to analyze Medicaid and Medicare laws and regulations as they relate to program issues and prepare high quality and well written documents.

Other responsibilities include:

Takes initiative to use subject matter expertise to identify and propose solutions to program needs;
Coordinates and collaborates with internal and external stakeholders to develop policy;
Oversees the development of operational policy, including contract, administrative rule, manual, and procedural requirements;
Assists in ensuring compliance with program policies and procedures, statutes, and rules; oversees and participates in the resolution of issues;
Facilitates meetings with stakeholders, including managed care organizations, provider associations, people receiving services, and advisory committee members;
Serves as agency liaison to pertinent advisory committees or workgroups;
Develops program policies, procedures, standards, and manuals;
Prepares high quality written reports, correspondence, and other documents;
Drafts legislative reports;
Develops and provides training; and
Analyzes program policies and legislation.

The position is not supervisory but may assign, oversee, and prioritize work of others. The position will work under limited supervision, with considerable latitude for the use of initiative and independent judgment.

Requirements

• Knowledge of Medicaid, Medicare, or long-term services and supports (LTSS).
• Knowledge of Federal and state Medicare and Medicaid laws and regulations
• Knowledge of Government organization and administration
• Knowledge of Principles of health and human services policy and planning
• Knowledge of State of Texas legislative processes.
• Skill in Analyzing, evaluating, and interpreting complex federal and state legislation and program policy
• Skill in Synthesizing, analyzing, and evaluating highly complicated policy and technical information
• Skill in Developing and implementing creative and workable solutions to complex problems and policy issues
• Skill in Researching, gathering, assembling, correlating, and analyzing facts and devising solutions based on the information available
• Skill in Communicate effectively orally and in writing, including the ability to adjust communications to fit the intended audience
• Skill in Working with internal and external stakeholders
• Skill in Project management
• Skill in Exercising sound judgment with limited information
• Skill in Working independently with limited direction.
• Ability to Analyze complex federal and state legislation, rules, and program policy and use the analysis to develop or revise Medicare-Medicaid program policy
• Ability to Work cooperatively as a team member in a fast-paced, deadline-oriented environment
• Ability to Lead or contribute to complex projects that require critical thinking, persistence, and problem solving
• Ability to Negotiate among multiple parties and resolve conflicts
• Ability to Navigate complex and dynamic systems and organizations
• Ability to Establish and maintain effective working relationships
• Ability to Manage multiple, sometimes conflicting tasks and projects at a time
• Ability to Use Microsoft Office Suite applications such as Outlook, Teams, Word, Excel, and Planner.
• Candidates must meet one of the following: 1) Bachelor’s degree from an accredited four-year college or university and at least two years' full-time work experience in health and human services; 2) Master’s degree in public affairs, social work, public health, or related field and at least one year of full-time work experience in health and human services; or 3) High School diploma and at least five years’ full-time work experience in a health and human services field.

Nice To Haves

• Master’s degree in public affairs, social work, public health, or public administration.
• Two years of full-time work experience in the health and human services field.
• Work experience in Medicaid or Medicare.
• Experience developing or overseeing advanced (senior-level) deliverables, reports, or other technical writing work products.

Responsibilities

• Oversees the analysis, development, implementation, and documentation of federal and state legislation and regulations.
• Develops and provides oversight healthcare policy, legislative analyses, research papers, reports, and responses to stakeholder inquiries.
• Works with internal and external stakeholders to develop, implement, and manage projects or special initiatives related to programs and services for people dually enrolled in Medicaid and Medicare.
• Establishes, facilitates, and participates in multiple workgroups and committees.
• May develop and provide training to internal staff and external entities.
• Prepares and approves high quality written documents, including program and project updates and summaries, executive memos, presentations, legislative reports, rules, waivers, and state plan amendments.
• Leads coordination of and consults with internal and external stakeholders, and keeps supervisor informed of pertinent issues.
• Other duties as assigned.

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.
• HHSC is a qualifying organization for the Federal Public Service Loan Forgiveness Program, which forgives the remaining balance on college student Direct Loans after making 120 qualifying monthly payments.
• Leadership commitment to invest in and foster your professional growth and career advancement.
• Being part of a team that impacts the lives of millions of Texans that depend on Texas Medicaid throughout Texas.
• Being on the ground level of healthcare policy development and implementation, including the opportunity to work closely with stakeholders such as federal partners, providers, advocates, managed care organizations, and other healthcare contractors.
• Engagement with the Texas legislative process, including the opportunity to analyze and inform legislators of potential impact of proposed bills.
• The opportunity to learn and engage with multiple domains of the healthcare delivery system, including managed care, fee-for-service, federal-state Medicaid partnerships and other activities related to the administration of the Medicaid program.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level