Texas Health & Human Services Commission-posted 25 days ago
Full-time • Mid Level
Remote • Austin, TX
1,001-5,000 employees
Administration of Human Resource Programs

Under the direction of the Quality Assurance Director within Health Care Regulation (HCR), the Program Specialist VII (Quality Assurance Program Analyst), performs highly advanced (senior-level) consultative and analytical work as a key member of the Quality Assurance Team. This role conducts quality assurance case reviews, manages data, and provides expert survey and investigative case consultations to clinical and non-clinical field staff who conduct federal and state regulatory activities in acute-care provider settings. These providers may include general or special hospitals, private psychiatric hospitals, limited services rural hospitals, ambulatory surgical centers, birthing centers, abortion clinics, end stage renal disease facilities, freestanding emergency medical care facilities, crisis stabilization units, narcotic treatment programs, special care facilities, and chemical dependency treatment facilities; and professional licensees, including licensed chemical dependency counselors and licensed sexual offender treatment providers. Key areas of quality assurance review include rule violations, enforcement eligibility, allegations of abuse, neglect, and exploitation, employee misconduct registry cases, and other complex or high-profile inquiries, such as those involving government relations, bill analyses, case appeals, and requests requiring a quality assurance perspective. Each review involves a thorough assessment and evaluation of complex information to ensure compliance with applicable policies and regulations. This process includes researching and interpreting relevant rules, analyzing complaints, reports, statements of deficiencies, and supporting evidence (e.g. medical records, policies and procedures, training records, and rosters), identifying areas for improvement, and providing actionable recommendations to drive successful outcomes. Strong writing skills are essential for this position, as is the ability to deliver clear, well-organized feedback to staff on their work products, maintaining professionalism and clarity in all communications. Additionally, the role involves comprehensive oversight and management of quality assurance data, including monitoring trends, forecasting, and reporting using program trackers, dashboards, and monthly reports to support ongoing program improvement and informed decision-making. Collaboration is central to this position, which serves as the enforcement liaison and works closely with cross-functional teams, including leadership, Field Operations, Regulatory Enforcement, Policies and Rules, Training, Legal, and other internal and external stakeholders to develop and implement best practices and process improvements that promote consistency and quality. Promoting staff development and a culture of quality improvement are essential components of this role. The position is responsible for planning, creating, and delivering impactful presentations, comprehensive training sessions, practical resources, and effective job aids to support program staff. In addition, it supports and guides staff through complex compliance reviews and program changes to foster growth, consistency, and high-quality performance. The position may also lead and support quality improvement projects and special initiatives to achieve program goals. Operating under minimal supervision, it allows for extensive latitude in the use of initiative and independent judgment. The ideal candidate demonstrates strong analytical, communication, and mentoring skills, and is comfortable working independently and collaboratively to drive program excellence and ensure compliance with all relevant standards.

  • Conduct comprehensive case reviews and consultations for clinical and non-clinical field staff across a wide range of acute-care providers and professional licensees, ensuring reviews are accurate, timely, and result in sound enforcement outcome decisions.
  • Evaluate violations to ensure findings are supported by sufficient evidence, comply with regulatory requirements, and contribute to consistent enforcement outcomes.
  • Research rules and regulations, review extensive evidence and reports, identify gaps and focus opportunities, and deliver actionable, high-quality, and well-received feedback and recommendations that improve decisions.
  • Maintain up-to-date knowledge of federal and state rules, regulations, and policies relevant to acute-care providers and professional licensees to ensure reviews reflect current standards.
  • Prepare intensive written reports and provide clear, well-structured, and consistent feedback to staff regarding their work products, supporting accuracy and quality in enforcement outcomes.
  • Oversees and manages quality assurance data, ensuring accuracy, timeliness, thoroughness, consistency, and quality in tracking, trending, forecasting, and reporting.
  • Maintains program trackers, dashboards, and monthly reports to support program improvement and inform decision-making.
  • Analyzes and interprets program data to identify trends, gaps, and opportunities for improvement, communicating findings in a clear, consistent, and actionable manner.
  • Effectively collaborates with cross-functional teams, including leadership, Field Operations, Regulatory Enforcement, Policies and Rules, Training, Legal, and other internal and external stakeholders to develop and implement best practices and process improvements that promote consistency and quality.
  • Maintains strong partnerships and effective communication between QA and Regulatory Enforcement teams to ensure collaborative problem-solving and continuous improvement efforts.
  • Attends enforcement meetings and informal conferences and incorporates feedback to improve practices.
  • Identifies and implements opportunities for efficiency, innovation, and program development through timely, thorough, and consistent quality assurance data analysis and feedback.
  • Contributes to the development and improvement of internal processes, procedures, and program goals, ensuring high standards of quality and consistency.
  • Supports compliance teams and participates in quality improvement initiatives, ensuring recommendations are practical, well-received, and result in measurable improvements.
  • Plans, develops, and delivers presentations, training, resources, and job aids to program staff, ensuring materials are timely, thorough, consistent, and positively received.
  • Mentors, trains, and guides staff through complex compliance reviews and program changes, fostering professional growth, consistency, and high-quality performance.
  • Leads and supports quality improvement projects and special initiatives to achieve program goals.
  • A bachelor's degree from an accredited four-year college or university. Relevant work experience may be substituted for education.
  • A minimum of two years of experience conducting formal quality assurance or enforcement activities, such as case reviews, case consultations, administrative reviews, or appeals is required.
  • Experience researching, interpreting, and applying regulatory statutes and rules to compliance related activities, such as surveys, inspections, and complaint investigations, is required.
  • Experience with data collection, analysis, monitoring, and reporting is required.
  • Experience working in a regulatory, investigations, or protective services program is required.
  • Knowledge of: Federal and state laws and regulations relevant to HHSC Health Care Regulation and Long-term Care functions, including survey and complaint processes.
  • Knowledge of: Quality assurance principles and processes.
  • Knowledge of: Program planning and implementation strategies.
  • Knowledge of: Data collection and analysis methodologies.
  • Skill in: Researching, interpreting, and applying statutes, rules, policies, and procedures accurately.
  • Skill in: Building and maintaining data trackers and dashboards; conducting comprehensive data analysis to identify trends, generate reports, and forecast outcomes using Excel or similar software.
  • Skill in: Reviewing work and providing constructive feedback to team members.
  • Skill in: Collaborating effectively with internal and external stakeholders.
  • Skill in: Communicating clearly and concisely in both verbal and written formats.
  • Skill in: Articulating complex issues and training others effectively.
  • Skill in: Coordinating tasks and making informed decisions.
  • Skill in: Applying critical thinking to identify problems, evaluate alternatives, and recommend solutions.
  • Ability to: Organize and present large, complex information in an understandable format.
  • Ability to: Gather, assemble, correlate, and analyze facts to support decision-making.
  • Ability to: Identify and implement opportunities for process improvements and adopt new tools.
  • Ability to: Communicate effectively and adjust approach based on audience needs, including presenting to large groups or executive leadership.
  • Ability to: Mentor and empower others, fostering professional growth and skill development.
  • Ability to: Manage multiple projects with competing priorities and deadlines.
  • Experience working in Health Care Regulation or Long-term Care Regulation is preferred.
  • Experience assessing provider deficiencies against applicable regulations is preferred.
  • 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.
© 2024 Teal Labs, Inc
Privacy PolicyTerms of Service