Medicaid Program Policy Analyst

TX-HHSC-DSHS-DFPS•Austin, TX

2d•$4,523 - $7,254•Hybrid

About The Position

The Program Policy team within the Medicaid and CHIP Services (MCS) Office of Policy is seeking a Program Specialist V to serve as a policy analyst and subject matter expert on a variety of program policy topics related to Medicaid and CHIP services and managed care. Duties involve performing advanced consultative and technical work related to the analysis, planning, development, implementation, and maintenance of managed care policy. Policy area examples include but are not limited to: the statewide STAR program, hospice services, service coordination, targeted case management, non-emergency medical transportation, Federally Qualified Health Centers (FQHCs), complaints and appeals, and services for justice-involved youth. The Policy Analyst provides subject-matter expertise to agency staff, government agencies, community organizations, managed care organizations, provider organizations, and the public. The position may serve as the lead in the implementation and ongoing management of complex program initiatives. Other responsibilities include: Coordinate and collaborate with internal and external stakeholders to create and update policies, procedures, contract requirements, administrative rules, business rules, and communications to external stakeholders and contractors. Develop project timelines for assigned projects, monitor and report on progress, and update timelines as necessary. Coordinate and collaborate with the internal and external stakeholders to schedule standing meetings, respond to policy inquiries, draft reports, update content in public documents and websites, and manage shared mailboxes. Assist in researching managed care organizations’ compliance with program policy contractual requirements. Participate in and help to facilitate meetings with stakeholders, including managed care organizations, provider associations, people receiving services, and subject matter experts. 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. This position works under limited supervision, with considerable latitude to exercise initiative and independent judgment. The Policy Analyst (Program Specialist V) reports to a Manager for Program Policy in the Medicaid and CHIP Services Division.

Requirements

Federal and state Medicaid and CHIP laws and regulations
Government organization and administration
Program issues related to Medicaid services for children and adults
Principles of health and human services policy and planning
State of Texas legislative processes
Analyzing, evaluating, and interpreting complex federal and state legislation, program, policy, and operations issues
Project management policy analysis, and performing policy research
Synthesizing, analyzing, and evaluating highly complicated and technical information
Translating policy and technical information into easily understandable and concise documents and oral presentations
Developing creative and workable solutions to complex problems and policy issues
Facilitating stakeholder and different workgroup meetings
Develop, amend, and interpret program policies, rules, and contract requirements related to Medicaid and CHIP Services
Research, gather, assemble, correlate, and analyze facts and devise solutions based on the information available
Work with a team under pressure, negotiate among multiple parties, resolve conflicts
Exercise judgment and work independently with minimum supervision
Work cooperatively as a team member in a fast-paced, deadline-oriented environment
Establish and maintain effective working relationships with various levels of personnel in government entities
Use Microsoft Office Suite applications such as Outlook, Teams, Word, and Excel
Communicate effectively orally and in writing, including the ability to adjust communications to fit the intended audience
Work with diverse groups of people, including stakeholders, who have a variety of opinions
High school diploma and at least five years of full-time work experience in a health and human services field
Bachelor’s degree from an accredited four-year college or university and at least one year of full-time work experience in a health and human services field
Master’s degree from an accredited college or university in public health, public administration, public affairs, social work, or closely related field

Nice To Haves

Experience or education in a field focusing on the delivery of healthcare, public health, state government, social work or other related field.
Demonstrated experience with developing advanced deliverables, reports, or other technical writing work products.

Responsibilities

Collaborates with other areas of MCS and HHSC to plan, develop, implement, monitor, interpret, and evaluate Medicaid programs, policies, MCO contract requirements, business rules, administrative rules, waivers, and state plan.
Evaluates MCO compliance with program policies and procedures, contract requirements, statutes, rules, and takes corrective action if needed.
Plans, monitors, and evaluates the implementation of state and federal legislation and regulations.
Analyzes state legislation, federal legislation, and federal rules to evaluate their impact on MCS and stakeholders, including MCOs, service providers, and members.
Establishes, facilitates, participates in, and develops agendas for relevant workgroups and committees, including inter-agency workgroups and committees.
Coordinates and provides requested training to internal staff and external entities.
Prepares high quality written documents such as project updates, reports, PowerPoint presentations, communications to stakeholders and contractors, executive memos, policy and project summaries, legislative reports, administrative rules, waivers, and state plan amendments.
Other duties as assigned.