Managed Care Contracts and Oversight PSVI

TX-HHSC-DSHS-DFPS • Austin, TX

1d • Hybrid

About The Position

The HHSC Medicaid CHIP Services (MCS) division seeks a highly qualified candidate to fill the position of Program Specialist VI. MCS is driven by its mission to deliver quality, cost-effective services to Texans. This position makes a significant contribution to MCS’s mission by ensuring that MCCO meets statutory requirements and implements audit recommendations within prescribed timeframes. The position reports to the director of Managed Care Compliance and Operations. This position performs highly advanced (senior-level) consultative services and technical assistance work. Work involves planning, developing, and implementing major agency program(s) and providing consultative services and technical assistance to program staff, governmental agencies, community organizations, or the general public. This position may train, assign, and/or prioritize the work of others. This position works under minimal supervision, with considerable latitude for the use of initiative and independent judgment.

Requirements

• Knowledge of federal laws, regulations, and processes regarding Medicaid and CHIP.
• Knowledge of public administration and management techniques and program management processes.
• Experience in organizational development and/or business process improvement.
• Ability to work under minimal supervision, with considerable latitude for the use of initiative and independent judgment.
• Ability to gather, assemble, correlate, and analyze facts; to devise solutions to problems; to conduct sophisticated research; to prepare reports; to develop, evaluate, and interpret policies and procedures; to communicate effectively; and to train, lead, assign, and prioritize staff workloads.
• Skill in using personal computer application software such as Visio, MS Word, PowerPoint, Excel, or similar programs.
• Skill in written and oral communication, including the ability to make public presentations and write technical information in an understandable format.
• Ability to work cooperatively as a team member in a fast-paced, deadline-oriented environment.
• Ability to communicate effectively.
• Graduation from an accredited four-year college or university with major coursework in Health Care Management, Health Care Information Technology, or Health Care Administration is generally preferred.
• Minimum of one year of experience with Medicaid/CHIP, Medicaid/CHIP dental, and managed care programs, policies, procedures, contracts, and service delivery mechanisms is required.
• A minimum of one year of experience in contracts, contract management, or contract principles is required.
• A minimum of one year of experience in using a PC and Microsoft Office is required.

Responsibilities

• Oversees the performance of a variety of technical, training, research, planning, policy, program assessment, and administrative activities for the Managed Care Compliance & Operations unit.
• Oversee the analysis, implementation, and documentation of program policies, procedures, manuals, and standards, including the analysis and redesign of business processes, and provide training and technical assistance to staff. Serves as a subject matter expert and resource for the unit.
• Organizes and prepares materials in response to requests for program information.
• Prepares administrative reports and studies, and performs specialized research projects
• Explains and oversees compliance with program and agency statutes, rules, and contracts, and takes corrective action(s) as needed. Consults with internal and external stakeholders to resolve problems, discuss program effectiveness, and identify training needs. Determines trends and resolves operational problems.
• Performs other duties as assigned, timely and accurately.
• 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. Attends work on a regular, predictable schedule in accordance with agency leave policy.

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
• Number of Employees: 1,001-5,000 employees