Operations/Readiness Coordinator (PSVI)

TX-HHSC-DSHS-DFPS•Austin, TX

15d•$5,099 - $8,305•Hybrid

About The Position

The Operations/Readiness Coordinator reports to the Senior Manager of Operations and Readiness located in the Managed Care Contracts and Oversight (MCCO) division of the Medicaid/CHIP Services (MCS). This position works under minimal supervision, with considerable latitude for the use of initiative and independent judgment. This position performs highly advanced (senior-level) consultative services and technical assistance work for the Managed Care Contracts and Oversight (MCCO) section. The position is responsible for development and recommendations for appropriate courses of action to address identified issues and will communicate with the Operations/Readiness Senior Manager in a timely manner. Performs highly advanced (senior level) consultative services, analysis, and oversight of compliance with contract standards. Work for this position involves leading operational and readiness initiatives such as deliverables, timelines for implementation, system changes, readiness reviews, operational reviews, and information sessions. Work also involves cross-divisional collaboration, planning, developing, and implementing major agency program(s). Provides highly complex consultative services and technical assistance to program staff, Managed Care Organizations (MCO), governmental agencies, community organizations, or the public. Work includes leading analysis, research, collection of data, development and review of tools for Operational and Readiness initiatives. Prepares management responses and reports with analysis. This position trains, leads, assigns, prioritizes and performs quality assurance of the work of others. Frequent travel is required. This position works with all aspects of the Medicaid/CHIP programs, including Medicaid Managed Care, DMOs, MCOs, contracts, policies and/or procedures. Leads and coordinates operations and readiness activities across the MCS Division and managed care organizations. Work includes evaluating MCO adherence to contracts, policies, programs, other government assistance and programs and private sector resources. Performs other duties, as assigned.

Requirements

Certified Texas Contract Manager (CTCM) certification required. Must maintain CTCM certification.
Knowledge of managed care systems; subsidized health insurance, including Medicaid, Medicaid Managed Care, and/or CHIP; contract management and compliance principles; team dynamics and human motivation theory.
Skill in leading teams to achieve organizational goals, objectives, and performance targets; leadership, project management, and time management; planning, development, and implementation of systems, programs, and processes designed for operational oversight; using personal computer application software such as Microsoft Word, Excel, PowerPoint, or similar programs; written and oral communication, including making public presentations, writing technical information in an understandable format, and producing research and analytical reports; establishing and maintaining effective working relationships with managers, co-workers, other agency personnel, and the public; leading workgroups and meetings to accomplish unit goals and objectives.
Ability to develop and write policies and procedures; work under limited direction and exercise initiative and independent judgment; gather, assemble, correlate, and analyze facts and data, and devise solutions to problems; identify knowledge gaps, train staff, and assign and prioritize work; research, develop, and deliver internal policies and procedures; oversee activities, goals, and objectives, and develop solutions to technical and administrative problems; organize resources to achieve desired outcomes; ensure accountability and motivate staff to build morale.
A minimum of 120 semester hours from an accredited college with major course work in a field related to health and human services. Graduation from an accredited four-year college or university with major course work in a field relevant to assignment is generally preferred. Experience and education may be substituted for one another.
Minimum of three years of experience with Medicaid and CHIP managed care programs, policies, procedures, contracts, and service delivery models.
Minimum of three years of experience of contract management and contract principles.
Minimum of three years of experience in using a PC and Microsoft Office Suite including Word, Excel, PowerPoint, and Outlook.

Nice To Haves

Relevant team lead/supervisory experience preferred.

Responsibilities

Coordinates standardized oversight of program and MCO contractual compliance through Operational and Readiness Reviews which include: a) collection, analysis, and reporting of data for trends among MCO/DMO/MTO performance; b) evaluation of MCO compliance with contract(s) deliverables and regulatory standards; and, c) identification and resolution of MCO contractual issues. d) develops and makes recommendations for appropriate courses of action to address identified issues and communicates them to the Senior Manager. (20%)
Leads, facilitates, and collaborates complex planning and technical assistance related to operations and readiness activities across the MCS Division and managed care organizations. Coordinates with internal and external stakeholders to facilitate creation, review and assessment of programs and MCO contracts, policies and/or procedures, contract compliance issues and improvements to promote efficiency, innovation, and achievement of effective outcomes and processes, risk mitigation, and contract compliance activities. (20%)
Coordinates, leads, and facilitates operational on-site and desk readiness reviews, highly technical information sessions, and reviews of complex contractor materials. Performs QA checks on staff reviews and assists team staff in preparing reports based on findings from formal reviews and assessments of MCO operations and readiness. Develops timelines, policies, guidelines, and operating procedures for the unit, and communications for stakeholders. (20%)
Ensures the operational effectiveness of the MCO Operations and Readiness across MCS is maintained through cross-divisional planning and prioritizing technical assistance and training of staff, including Readiness team activities, and assigning policy reviews to staff related on MCO service delivery models. Analyzes processes and makes change recommendations to leadership. Prepares management responses and reports with analysis and appropriate project prioritization. (20%)
Participates in the development and evaluation of managed care contracts, Requests for Proposals (RFPs), and evaluation tools through thorough analysis of rules, bills and federal/state laws with implications for Medicaid and CHIP programs. Responds to legislative, open record, and audit requests within specified timeframes. (10%)
Establishes and maintains effective working relationships and communication with staff from other agencies and organizations, appropriately interacts with others, and provides timely responses to requests and inquiries. Represents MCCO in a positive manner. Demonstrates commitment to the goals of the Medicaid/CHIP services, shows initiative to take on new projects, is team-oriented and committed to outstanding customer service, and focuses on promoting efficiencies and accountability. Communicates with manager in a timely manner regarding problematic situations and applies proper judgment to ensure action taken is appropriate. Attends work on a regular and predictable schedule in accordance with agency leave policy. Trains and leads others. Performs related work as assigned, timely and accurately. (10%)