PE Program Coordinator

TX-HHSC-DSHS-DFPS•Austin, TX

4d•$5,099 - $8,305•Hybrid

About The Position

The Texas Health and Human Services Commission (HHSC) Medicaid CHIP Services (MCS) department seeks a highly qualified candidate to fill the position of Program Specialist VI (Program Coordinator) in the Provider Enrolment (PE) program. The ideal candidate thrives in an environment that emphasizes: teamwork to achieve goals, excellence through high professional standards and personal accountability, curiosity to continuously grow and learn, critical thinking for effective execution, and integrity to do things right even when what is right is not easy. Under the supervision of the Provider Enrollment Manager, the Program Specialist VI will serve as an PE liaison between Texas HHSC, state contractors and Medicaid providers to perform highly advanced consultative and technical work related to PE program policies and processes in a dynamic and fast-paced environment. Work includes researching and interpreting program policies, procedures, rules, regulations, guidance, and standards as they relate to Medicaid provider enrollment. Provides technical assistance to program and PE staff, providers, and State Medicaid contractors. Responds to legislative and external inquiries and requests. Prepares complex written reports. Researches and resolves PE related provider complaints and escalations. Leads special projects. Performs legislative bill analysis. Serves as a liaison and information conduit between PE and Medicaid providers.

Requirements

Graduation from an accredited four-year college or university. Relevant experience may be substituted for each year of required education.
Three years’ experience preferred researching, analyzing, developing and communicating policy to stakeholders.
Three years’ experience handling customer escalations.
Three years’ experience preferred leading large workgroups or special projects or hosting webinars or virtual online meetings or events.
Two years’ experience preferred working in the healthcare industry.
Knowledge or experience with Medicaid provider enrollment preferred.
Knowledge of Medicaid or other HHSC programs preferred.
Skill in developing accurate, clear, and succinct program policies.
Skill in analyzing, interpreting and evaluating laws, policies and procedures.
Skill in leading large workgroups and in making presentations.
Skill in using Outlook, Word, and Excel.
Excellent verbal and written communication skills.
Proficient in web conferencing tools (GoToMeeting & Teams).
Ability to establish and maintain strong working relationships with stakeholders.
Ability to work in a dynamic and fast-paced environment.
Ability to interpret statutes, state, and federal rules and regulations.
Ability to prepare complex written reports.
Ability to review and analyze contract documents and complex data sets.

Responsibilities

Assists the Provider Enrollment unit with PE related questions and complaints. Works with internal and external stakeholders, including contracted vendors, to research and disposition provider questions and complaints.
Leads or represents PE in workgroups and meetings to disseminate information on PE policy and programmatic initiatives. Prepares agenda, facilitates discussions, and maintains effective working relationships with PE representatives. Coordinates with stakeholders on major initiatives including workgroups, technical changes, policy changes, and other major projects. Coordinates with other HHSC areas involved in managed care. Identifies operational, policy and technical impacts to PEs, shares information with stakeholders and coordinates to ensure successful implementation. Solicits feedback from internal and external stakeholders on proposed program and policy changes.
Provides technical assistance to program and PE staff, providers, and State Medicaid contractors. Serves as an expert on managed care policies and processes that affect PE; provides consultative support to other PE staff on PE policies and processes. Plans, researches, coordinates PE program policies and rules that affect other HHSC program areas. Recommends PE contract updates for PE.
Interprets policies, procedures, rules, regulations and standards related to program to other program areas. Performs legislative bill analysis. Researches PE contracts and processes.
Responds to legislative and external inquiries and requests. Prepares complex written reports, presentations and other PE program deliverables. Presents program policy at meetings. Participates in other workgroup meetings. Communicates with industry stakeholder groups such as provider associations and health plan associations. Drafts guidance and notices to providers with program updates.
Leads and participates in operational projects affecting the unit. Coordinates with other program areas with minimal oversight. Serves as a lead team member providing direction to others. May train others.