Provider Relations Representative

TX-HHSC-DSHS-DFPS • El Paso, TX

6d • $3,793 - $4,857 • Onsite

About The Position

Under the direct supervision of Program Supervisor and overall direction of the Program Manager performs moderately complex (journey-level) consultative services and technical assistance to program staff, community organizations and Texas Health Steps (THS) Providers. Serves as a THS Provider Representative and liaison to provide technical assistance on THS specifics and requirements. Duties include, performing an array of technical, trainings, research, planning, and program assessment related to the Texas Health Steps (THS) program. Collaborates, communicates and assists with Managed Care Organizations (MCO’s) and Texas Medicaid (TMHP) for providers regarding billing issues. Performs consultative visits to Providers and private agencies to discuss program issues, markets the program and conducts THS Workshops. Performs comprehensive reviews of THS literature, statutes, rules, and/or policies and prepares reports as needed. May provide guidance to other THS Provider Representatives. Works collaboratively with public health staff in the event of a regional or state disaster. Works under general supervision with limited latitude for the use of initiative and independent judgement. Maintains confidentiality.

Requirements

• Knowledge of Health & Human Service Medicaid programs, Medicaid Managed Care and Medicaid Managed Care Organizations
• Knowledge of public health and public health practices.
• Knowledge of recommended medical developmental screenings for children birth to 20 years.
• Knowledge of recommended dental screenings for children birth to 20 years
• Skill in public speaking
• Skill in oral and written communication
• Skill in adult training methods
• Skill in analyzing and devising solutions for problems identified
• Skill in interpreting and researching policies, procedures and regulations
• Skill in working with community agencies, groups or coalitions
• Skill in working independently, to organize workload, establish priorities and complete assigned tasks
• Skill in Microsoft Office Products
• Ability to interpret and apply program policy
• Ability to work in teams and take direction from supervisors
• Ability to establish and maintain effective work relationships with internal and external clients and colleagues
• Ability to develop training materials
• Ability to work independently with minimum supervision
• Must possess a valid Class C Texas driver's license, or equivalent license from another state.
• Bachelor's degree in human services, public health, education, social work or related field from an accredited college or university.
• Experience working in the Healthcare industry/field.
• Experience conducting training and/or providing technical assistance.
• Experience in conducting/coordinating projects, events and activities in the community
• Experience in the use of computers and related equipment, including the use of Office Suite, Spreadsheets, databases and presentation software required.
• Experience working with healthcare providers, community organizations or external stakeholders

Nice To Haves

• 2 year preferred experience working in the Healthcare industry/field.
• 2 year preferred experience conducting training and/or providing technical assistance.
• 2 year preferred experience in conducting/coordinating projects, events and activities in the community
• 2 year preferred experience working with healthcare providers, community organizations or external stakeholders

Responsibilities

• Provides education and updates to retain existing and new medical, dental and case management providers; conduct education activities to community stakeholders regarding THS and Medicaid Services.
• Makes consultative visits to providers to discuss program issues, updates about programs, conduct trainings and/or assist providers with interpreting program policies and procedures.
• Assist providers with provider issues or enhance the knowledge of THS providers around program policy, requirements and procedures.
• Collaborates, communicates and assists with Managed Care Organizations (MCO’s) and Texas Medicaid (TMHP) for providers regarding billing issues.
• Escalates complex problems to central office timely to meet the needs of the provider.
• May assist medical and dental providers in the resolution of client related problems with community resources for referrals.
• Assists with compiling, analyzing and reporting of the THS activities to meet regional program goals and objectives and reporting to Program Manager.
• May assist Providers with consumer complaints and corrective action plans with guidance and interpretation.
• Ensures that provider information is updated annually in appropriate database as determined by central office or regional needs.
• Contact enrolled medical and dental THS providers at a minimal annually, to provide technical assistance with an on-site visit that promotes education, outreach and training.
• Identifies provider training needs and offers appropriate training and educational sessions.
• Maintains Vision & Hearing Trainer Certification and conducts provider trainings as requested.
• Participates in community activities for the promotion and marketing of THS program.
• Contacts potential medical, dental or CPW providers to explain the THS program and works collaboratively with public health partners to develop strategies to increase number of THS providers and retain current providers.
• Attends and participates in regional and statewide THS meetings for program planning.
• Actively participate and serve in a supporting role to meet the agency’s obligations for disaster response and/or recovery or Continuity of Operations (COOP) activation.
• Maintains an acceptable driving record, a valid class C Texas driver's license.
• Completes all Public Health Emergency Response, COOP, and other state mandated trainings.
• Reports time, labor and travel information in a timely manner.
• Other duties as assigned by program manager including special assignments.

Benefits

• insurance coverage and other benefits available through the State of Texas Group Benefits Plan administered by the Employee Retirement System of Texas (ERS).

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level