Program Management Spec III (Production Support Mgr)

TX-HHSC-DSHS-DFPS • Austin, TX

1d

About The Position

The Medicaid and CHIP Services (MCS) department seeks a qualified candidate to fill the position of Production Support Manager (Program Management Specialist III) to provide leadership in support of the Long-Term Care (LTC) Products unit.

This position reports to the LTC Products Director within the Business Automation Support area. The role performs team management, vendor contract oversight, and cross-team collaboration to support LTC Operations and LTC data/system maintenance. The Production Support team within the LTC Products unit supports the processes, data, and systems that correctly and timely authorize and pay LTC provider fee-for-service claims as well as the assessment and enrollment forms for LTC Managed Care programs. When production issues arise that impact multiple LTC functions and stakeholders, this position leads activities to coordinate and communicate with the system custodian(s) to identify and implement resolutions.

Responsibilities include but are not limited to:

Oversight and monitoring of the Texas Medicaid Contract administered by Texas Medicaid & Healthcare Partnership (TMHP) on behalf of HHSC for LTC claims processing and payment.
Monitor the execution of LTC Online Portal (LTC OP) system maintenance outlined in the Application Maintenance and Development (AMD) contract.
Oversight and management of the LTC Products Production Support Team Tier 3 queue and processes.
Liaisons with LTC system vendors and HHSC IT for automation coordination and communications.
Oversight and coordination of LTC audit and legislative issues.
Represents LTC Products in stakeholder meetings; provides subject matter expertise on the LTC CMS and LTC OP processes; identifies opportunities for improvement and approves updates.

This position will plan, assign, and supervise a team of state staff and contracted resources. The ideal candidate can work under minimal supervision; thrives in an environment that emphasizes teamwork; displays excellence through professional standards, personal accountability, and integrity.

Requirements

• Knowledge of Medicaid and/or Long-Term Care program rules and policies.
• Knowledge of LTC systems such as CMS and the LTC OP.
• Knowledge of TMHP operational and technology organization.
• Knowledge of Staff development and personnel performance management policies.
• Skill in Directing and collaborating with different teams on complex maintenance research and recovery efforts.
• Skill in Communicating effectively both orally and in writing as appropriate for the needs of the audience.
• Ability to Establish, implement and evaluate program initiatives, goals, and objectives.
• Ability to plan, assign, and/or supervise the work of others.
• Ability to analyze and prepare documents, reports, and correspondence.
• Ability to Manage staff and apply personnel management policies/procedures.
• Experience working with HHSC LTC operations and systems.
• Experience managing or supervising personnel.
• Experience working with TMHP.
• Experience identifying, troubleshooting, and overseeing resolution of issues that impact Medicaid systems.
• Contract management experience

Nice To Haves

• Experience with Home and Community-Based Services (HCS) and Texas Home Living (TxHmL) Waiver Programs.

Responsibilities

• Manages the day-to-day operational and production support activities of the section. Resolves issues related to provider claim payment and service authorizations.
• Provides leadership and guidance to staff performing the daily operational activities. Plans section priorities and effective evaluation tools to measure progress towards meeting the goals and objectives of the program.
• Enforces team policies and procedures. Reviews audit results to provide direction and guidance. Performs ongoing assessment of team activities to identify process improvements, efficiencies, monitoring, and automation opportunities. Provides updates to management for key issues.
• Assigns resources to work efforts and monitors progress as appropriate while managing competing priorities.
• Supervises LTC reference data maintenance activities.
• Manages activities that measure contract compliance of the TMHP vendor. Escalates non-compliance. Provides feedback on future contract requirements and measures for Production Support activities.
• Monitors the AMD vendor system maintenance contract compliance. Escalates non-compliance. Provides feedback on future contract requirements and measures for Production Support activities.
• Supports the Incident Management process for LTC systems.
• Participates in Maintenance Release reviews/demos. Supports application release planning and test environment coordination.
• Oversee/monitor complex research and analysis within LTC systems to identify, test, and resolve issues that impact provider claims payments and service authorization.
• Serves as a subject matter expert, providing technical guidance to agency staff and stakeholders on activities and functions related to LTC systems. Communicates effectively with audiences of various technical levels. Collaborates across teams to address issues impacting LTC customers.
• Actively participates in workgroups and meetings; acts as a liaison with TMHP, AMD and HHSC IT; solicits impacts from stakeholders and makes recommendations to leadership on solution options. Participates in knowledge transfer for large enhancement releases to identify staff training needs.
• Responds to requests from program areas, agency leadership, legislators, auditors, attorneys, and other relevant parties.
• Supervises, supports, and leads state personnel and contracted resources.
• Manages and develops staff by establishing performance goals; maintains and reviews performance data.
• Manages vacancies, assigns work, completes performance evaluations, approves leave requests, and monitors attendance.
• Applies the appropriate staff performance and management policies and procedures, updates management on personnel issues.

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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed