Performance Management Specialist

TX-HHSC-DSHS-DFPS • Austin, TX

13d

About The Position

The Program Specialist VI reports to the Manager of the Federal Coordination, Rules and Committees unit of the Medicaid/CHIP Division. The position performs advanced (senior level) consultation and technical assistance work in support of Medicaid waiver activities. In particular, the position serves as the lead for quality oversight of the 1915(c) and 1915(b) waivers in addition to consulting on 1115 quality activities. Works with staff to identify issues, resolve problems and meet timelines.
Communicates with the federal Centers for Medicare and Medicaid Services (CMS) as necessary in relation to specific assignments. Reviews quality assurance language in waivers and processes to ensure compliance with federal regulations and guidance governing quality improvement plans. Recommends process improvements. Leads or participates in relevant work groups, meetings and priority projects. Works under limited supervision with considerable latitude for the use of initiative and independent judgment.

Requirements

• Knowledge of state and federal laws and regulations governing quality improvement activities required under Medicaid waiver programs.
• Knowledge of performance measure development, analysis and evaluation
• Skill in project management oversight, including monitoring of deadlines and compliance with policies and procedures relevant to the project.
• Skill in facilitating meetings and ensuring that participants meet their deliverables.
• Possesses intermediate to advanced excel skills.
• Skill in researching and analyzing complex program and policy issues.
• Ability to exercise sound judgment in making decisions.
• Ability to identify project risks and gaps and to develop recommendations to address issues.
• Ability to communicate effectively, both orally and in writing.
• Ability to analyze financial data.
• Ability to work with people under pressure, negotiate among multiple parties, resolve conflicts and establish and maintain effective working relationships.
• Ability to work cooperatively in a team environment.
• Bachelor's degree from an accredited 4-year college or university with a focus in performance management and analysis and trending of data related to Medicaid or other social services programs.
• Experience in researching and analyzing complex program and policy issues.

Responsibilities

• (30%) Serves as the lead on coordination of projects, policies and issues affecting quality assurance in multiple waivers. The position reviews and identifies issues for further inquiry related to performance measure and financial data reported. Works collaboratively with performance staff and with staff on the HHSC Program Policy unit within the Federal Coordination, Rules and Committees team. Completes coordination assignments with input from other team members as needed. May assign work to others and ensures that such assignments are completed in accordance with established deadlines. Facilitates and participates in meetings for assigned waivers and projects related to quality assurance, including meetings with advocacy groups, provider associations and other stakeholders as appropriate.
• (20%) Facilitates quarterly performance measure review meetings for the 1915(c) long-term services and supports waivers and 1915(i) services. Reviews performance measure reports in advance of meetings and in consultation with other team members and other enterprise agency staff. Identifies potential risks and develops strategies to mitigate or avoid risk. Ensures that meetings are held on a schedule consistent with waiver requirements.
• (20%) Performs highly advanced consultative and technical assistance work in support of 1915(b), 1915(c) and/or 1115 Medicaid waivers as assigned. Understands waivers, applicable state and federal laws, and CMS technical guidance. Develops and implements quality improvement project plans in order to complete waiver submissions in accordance with federal and state requirements. Adheres to tight timeframes. Accurately advises program staff. Coordinates resource sharing, question referral and exchange of information between the enterprise agencies and federal partners for assigned waivers and projects. Reviews waiver activities related to quality and financial reporting and other information prior to submission to CMS to ensure quality and accuracy. Works with program staff, legal staff and management to address any questions or concerns prior to submission. Develops high quality written project updates, summaries, and other documents as requested. Researches federal regulations and guidance related to quality assurance and reporting as needed to address implementation or operational issues. Escalates issues for management assistance and guidance as needed to avoid risk.
• (15%) Serves as the primary point of contact for CMS on issues related to quality assurance and the Appendix H Quality Improvement Plan included in all 1915(c) waivers. Reviews, distributes, and responds to CMS communication regarding waiver quality. Facilitates conference calls with CMS, as needed.
• (5%) Assists with legislative bill analysis as requested, particularly in relation to impact of proposed legislation on waiver quality.
• (5%) Documents policies and procedures for the position and maintains electronic records in accordance with unit procedures. Recommends process improvements to support timely and efficient waiver support operations.
• (5%) Other duties as assigned.

Benefits

• comprehensive benefits package includes 100% paid employee health insurance for full-time eligible employees
• defined benefit pension plan
• generous time off benefits
• numerous opportunities for career advancement

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 1-10 employees