Provider Representative

TX-HHSC-DSHS-DFPS • Lubbock, TX

10d

About The Position

DSHS is committed to hiring skilled and dedicated individuals who share a passion for public health to pursue our vision of A Healthy Texas. If you are looking to make an impact and tackle new challenges, we encourage you to consider a career with us.

Under the direction of the Specialized Health and Social Services Program Manager and the Texas Health Steps Supervisor with considerable latitude for the use of initiative and independent judgement, performs moderately complex consultative and technical assistance in the planning, development, and implementation of the THSteps program. Serves as a THSteps Provider Relations Representative responsible for recruitment, referral, and retention services, individually and in cooperation with the Health & Human Services' (HHS) Medicaid outreach contractors and peers. Provides consultative services resolving technical issues and providing/coordinating training for medical and dental providers. Serves as a regional contact on policy issues. Participates in program planning, development, and implementation of provider relation strategies. Assists with the development of surveys, analyzes survey data, prepares detailed and comprehensive administrative reports, and assists with the development and presentation of educational programs for community and professional groups to coordinate, improve and stimulate interest in the program. May train others. Maintains an organized work area and assists in ordering and storing any supplies and educational material. Other duties as assigned includes but are not limited to actively participating in a supporting role to meet the agency's obligations for disaster response and/or recovery or Continuity of Operations (COOP) activation. Such participation may require an alternate shift pattern, assignment, and/or location and overnight travel.

Requirements

• Bachelor's degree from an accredited college or university.
• Knowledge of current trends, principles and practices in public health, Medicaid, Managed Care, and the health-care delivery system.
• Knowledge of social service programs.
• Working knowledge of available resources on local, state, and national levels.
• Skill in public speaking and presentations, effective written communication, and professional training methods for adult audiences.
• Skill in developing and maintaining productive and effective working relationships with clinical staff, providers, and members of the community.
• Skill analyzing issues and devising solutions for identified problems.
• Skill in interpreting and researching policies, procedures, and regulations.
• Skill using and developing training materials, using tutorials/various software (Microsoft Word, Excel, Power Point, etc.)
• Ability to work effectively in teams and take directions from others and collaborate for common goal.
• Ability to compile professional reports and present findings of data in a clear and concise way.
• Ability to organize tasks, set priorities, and meet deadlines.
• Ability to work independently and effectively with minimal supervision.
• Must possess a current valid Texas driver's license and insurance for the appropriate vehicle.

Responsibilities

• TECHNICAL ASSISTANCE AND/OR TRAINING: Provides technical assistance and/or training to THSteps Medical and Dental providers to resolve issues and/or enhance the knowledge of THSteps program policy, requirements, and procedures. Provides referrals and education/training while identifying and responding to provider needs. Works with HHS’s Medicaid Administrative Claims Contractor and Managed Care Organizations to resolve simple problems. Provides timely escalation of complex problems to Supervisor for consultation with central office to meet the needs of the provider. Upon request, will assist providers to achieve timely resolution of client related problems, such as lack of transportation to medical appointments. Develops educational packets, training presentations, announcements, marketing materials and survey tools. Identifies provider training needs in coordination with regional Managed Care Coordinator for Managed Care Organization (MCO) groups. Assists the new provider with THSteps program planning, development, training, and implementation by providing technical assistance and consultative services.
• REGULAR CONTACT WITH PROVIDERS: Contacts enrolled THSteps providers at least once a year with an on-site visit. Ensures that provider information is reviewed and updated at least annually in an appropriate database as determined by central office or regional needs. The provider visit must be documented accordingly on the PRAR. The PRAR will be submitted to the Supervisor for approval on the 1st and 15th of each month, or the following business day if the office is closed. Monitors client access issues for the Region.
• RECRUITMENT ACTIVITIES FOR PROVIDERS: Conducts recruiting activities with medical and dental providers to explain the program and gauge their interest in becoming a THSteps provider. Develops strategies to increase number of THSteps providers in the region, specifically in rural counties. Communicates and collaborates with local and regional provider relations teams, Texas Medicaid and Healthcare Partnership (TMHP) staff, applicable regional committees, provider groups and other related organizations to develop, evaluate and improve recruitment strategies and enrollment activities.
• PARTICIPATION IN COMMUNITY EVENTS: Coordinates with Local Health Departments and internal Texas Department of State Health (DSHS) programs for intra-agency, cross-programmatic groups/programs. Participates in community activities for the promotion of THSteps program. Coordinates and provides technical assistance to community organizations for development and delivery of THSteps program specific training. Collaborates with/speaks to community and professional groups, assists in planning and developing educational programs to coordinate, improve and stimulate interest in the THSteps program. Schedules, prepares and presents information to community, professional groups and providers regarding THSteps program and related issues. Facilitates and/or participates in assigned community meetings. . Attends and participates in Regional and State THSteps trainings/meetings/conference calls.
• ADMINISTRATIVE TASKS: Submits timely and accurate regular administrative monthly reports according to program guidelines. Tasks can include monthly reports, time and leave entry, travel or documentation of activities with providers and listing of THSteps providers in the region.
• OTHER DUTIES AS ASSIGNED: Completes other duties as assigned by Regional Manager or Supervisor, regional leaders, or central office management, including special assignments. Prepares or assists in preparation of purchase requests for educational and training materials. Maintains an organized work area and supply storage area. May actively participate to meet the agency's obligations for disaster response and/or recovery activation.

Benefits

• DSHS offers 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: Entry Level
• Number of Employees: 1,001-5,000 employees