PERM Analyst

TX-HHSC-DSHS-DFPS•Austin, TX

4d•$5,798 - $7,981•Hybrid

About The Position

The Texas Health and Human Services Commission (HHSC) Medicaid CHIP Services (MCS) division is seeking a highly qualified candidate for the position of PERM Analyst (Program Specialist VII) on the MCS PERM Coordination team. We’re looking for someone whose work ethic and goals align with the MCS mission of delivering quality, cost-effective services to Texans. The ideal candidate thrives in an environment built on: Teamwork – working together to achieve shared goals, Excellence – high professional standards and personal accountability, Curiosity – a drive to continuously grow and learn, Critical thinking – sound judgment for effective execution, Integrity – doing the right thing, even when it’s not easy. Reporting to the PERM Review Manager in the office of MCS Strategic Business Operations, the PERM Analyst supports the state’s participation in the federal Centers for Medicare and Medicaid Services (CMS) Payment Error Rate Measurement (PERM) program review. This is a large, recurring review that identifies gaps and process improvement needs, and determines improper payment error rates for services provided to eligible Texans through Medicaid and the Children’s Health Insurance Program (CHIP). The ideal candidate brings strong skills in complex analysis, project management, organization, and clear, timely communication. Communication across the agency is essential at every stage of the PERM review. Efficiently understanding and relaying needs and outcomes helps streamline the state’s participation in the federal review. PERM review phases include planning, testing, reporting, corrective action plan development, and implementation. The analyst should be able to: Perform critical analysis and efficiently use tracking and monitoring software, Build and collaborate effectively with team and stakeholders, Communicate clearly and concisely, simplifying complex information for different audiences, Quickly build knowledge of Medicaid and CHIP policy and business functions. Success in this role requires engaging key stakeholders, managing expectations, meeting deadlines, learning how functions connect across the agency, and maintaining strong working relationships with state, internal, and external stakeholders. This role calls for an expert communicator who is meticulous and highly organized.

Requirements

Graduation from an accredited four-year college or university, with coursework relevant to audit, information technology, accounting, finance, public policy, law, or another business-related field.
Experience in auditing and coordinating external audits or reviews, or leading complex projects, processes, or initiatives.
Relevant work experience may substitute for education on a year-for-year basis.
Ability to collaborate with and motivate staff to perform at a high standard, serve as an example to others, and foster a culture of continuous improvement
Ability to work collaboratively across MCS and other divisions to accomplish shared objectives
Keen attention to detail and the ability to implement creative solutions to obstacles
Ability to balance team and individual responsibilities
Knowledge of Health and Human Services programs, functions, and systems
Knowledge of Medicaid and CHIP programs, functions, and systems
Knowledge of Audit procedures, processes, and federal and state regulations and regulatory bodies
Knowledge of Project management approaches and tools
Skill in Organizing and managing time across multiple, competing priorities, with strong problem-solving and critical-thinking skills
Skill in Building interpersonal relationships with stakeholders which includes leading and facilitating discussions and negotiations, resolving conflict, and maintaining effective working relationships with staff, stakeholders, and leadership at all levels
Skill in Writing action-oriented, clear, and concise correspondence for varied audiences
Skill in Analyzing and assessing interdependencies of complex programs, and evaluating rules, regulations, policies, and procedures
Skill in Coordinating and reviewing the work of others, providing constructive feedback
Skill in Scheduling, coordinating, and leading meetings
Skill in Using Microsoft Office Suite, including Outlook, Word, Excel, PowerPoint, Visio, Teams, and SharePoint
Ability to Collect, analyze, and evaluate complex technical information, translating it into clear, concise documents, reports, and presentations for stakeholders, leadership, and CMS
Ability to Conduct research, collect and analyze data, and present findings in a logical format
Ability to Make timely, effective decisions and ask the right questions to maintain timelines throughout the PERM cycle
Ability to Identify challenges and develop creative, workable solutions to complex problems
Ability to Articulate and share ideas clearly when collaborating with internal and external stakeholders
Ability to Build and maintain effective working relationships, and work cooperatively in a team environment

Nice To Haves

At least two years of experience in the Texas Medicaid program or similar health and human services program.

Responsibilities

Works collaboratively with team members and across MCS to identify innovative, effective solutions for stakeholders and staff.
Serves as the point of contact with CMS, its PERM contractors, state program experts, and leadership across the Texas HHS system (HHSC, DSHS, and DFPS). Identifies and informs the right HHS staff and management and ensures they participate in relevant portions of the PERM program. Schedules, attends, and distributes results of meetings and calls with CMS and its contractors. Collects, organizes, analyzes, and prepares information for submission to CMS and its contractors, as well as for internal tracking and reporting.
Directs and oversees PERM cycle activities, quickly building an understanding of complex, integrated Medicaid and CHIP processes. This includes learning: Fee-for-service (FFS) and managed care (MC) delivery models, Data differences for large and small state programs, Program policies and processes, Federal regulations and state policies for payment processing, records retention, and eligibility determinations. Key responsibilities include: Monitoring and coordinating large dataset submissions, ensuring lead times are communicated and deadlines are met, Coordinating meetings, including reserving workspace, as needed, Learning state systems’ access and provisioning processes to ensure reviewers receive timely, appropriate system access, Tracking the statuses of the sampled cases across tested components: (a) provider medical records, (b) claims data processing, and (c) eligibility determinations, Staying on top of all open requests and ensuring timelines are met, Monitoring concurrent review activities for obstacles, delays, or errors, and researching and collaborating to file timely difference resolutions and appeals when possible, Communicating clearly, both verbally and in writing, simplifying complex requests, educating new staff and stakeholders, connecting multiple program areas, and flagging potential errors, delays, or concerns to stakeholders and leadership, Creating, organizing, and maintaining essential PERM cycle files in SharePoint.
Receives, communicates, and coordinates information across all teams responsible for developing corrective action plans for finalized cycle errors. Coordinates with state management and staff to submit complete corrective action plans before CMS deadlines and provides periodic updates to CMS on implementation status. Quickly learns complex PERM topics through research and analyzes high-risk audit issues. Coordinates across program areas to develop resolution strategies. Prepares and presents detailed resolution responses, both orally and in writing. Creates, organizes, and maintains essential PERM cycle files in SharePoint.
Other duties as assigned.
Attendance is required on a regular, predictable schedule in accordance with agency leave policy.