Quality Improvement Advisor

TX-HHSC-DSHS-DFPS•Austin, TX

About The Position

Join the Texas Health and Human Services Commission (HHSC) and be part of a team committed to creating a positive impact in the lives of fellow Texans. At HHSC, your contributions matter, and we support you at each stage of your life and work journey. 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. Explore more details on the Benefits of Working at HHS webpage. The Delivery System Quality & Innovation (DSQI) team within the Medicaid CHIP Services (MCS) Office of Quality and Program Improvement seeks a highly qualified candidate to fill the position of Quality Improvement (QI) Advisor (Program Specialist VI). The mission of DSQI is to incentivize, innovate, and educate to improve health care quality. The DSQI team develops and implements innovative QI programs and incentives, provides education and technical assistance to increase the adoption of best practices, and evaluates the effectiveness of quality programs and interventions. The QI Advisor is selected by and directly reports to a DSQI Manager. The Advisor works under general direction with extensive latitude for the use of initiative and independent judgment. Responsibilities include developing approaches to reduce avoidable emergency department utilization, implementing an annual systematic process to analyze and prioritize quality innovation recommendations made by HHSC’s external quality review organization, collaborating within a team on provider and managed care organization (MCO) education initiatives and projects that address non-medical drivers of health (NMDOH), and serving as subject matter expert on quality measures in the state’s directed payment programs (DPPs). The QI Advisor’s work will include collaboration with internal and external stakeholders to advance identified QI goals. The DSQI team currently leads multiple high profile QI initiatives that are critical to the Medicaid program in Texas, such as the quality aspects of Medicaid DPPs, working with hospitals to reduce avoidable emergency department utilization, and the NMDOH Action Plan. The Advisor will work collaboratively as part of a team and also serve as a lead point of contact on selected DSQI quality initiatives. 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.

Requirements

A keen attention to detail.
Strong skills in communicating effectively both orally and in writing.
Knowledge of federal and state Medicaid and CHIP programs, services, and requirements.
Familiarity with key concepts of delivery system reform, healthcare innovation, or population health.
Familiarity with healthcare quality measurement and common data sources used for healthcare monitoring and evaluation.
Skill in project management.
Skills in conducting policy and data analysis, as well as performing research.
Skill in synthesizing, analyzing, and evaluating complicated and technical information and translating it into easily understandable and concise documents and oral presentations.
Skill in developing creative and workable solutions to complex problems and policy issues.
Ability to negotiate with multiple parties, internally across an organization and externally with stakeholders, resolve conflicts, and establish and maintain effective working relationships.
Skill in producing high quality presentations and documents for educational and other training purposes.
Strong skill in public speaking and presenting to internal and external stakeholders.
Ability to exercise judgment and work independently with minimum supervision.
Ability to organize and develop work plans and adhere to strict deadlines.
Graduation from an accredited four-year college or university with major course work in a field relevant to healthcare, human services, public health, social work, policy development, research or evaluation, or another related field.
Work experience in a field related to Medicaid, healthcare research, public health, state government, social work, policy analysis, or another related field.
Experience and education may be substituted for one another on a year-per-year basis.

Nice To Haves

Master’s degree with course work in a field relevant to healthcare, human services, public health, social work, policy development, research or evaluation, or another related field is preferred.

Responsibilities

Serves as a lead for planning and development of innovative provider-led quality initiatives to reduce avoidable emergency department utilization.
Works with stakeholders on identifying best practices and developing recommendations.
Contributes to legislative reports about reducing avoidable emergency room utilization.
Plans for and oversees the analysis, development, implementation and documentation of quality and program improvement initiatives based on recommendations from HHSC’s external quality review organization.
Analyzes data, determines trends and makes recommendations for QI.
Provides support to the staff leading QI initiatives such as provider and MCO education, and projects that address NMDOH.
Work products include analysis, research, presentations, written reports, and facilitation of stakeholder discussions.
Serves as subject matter expert on certain DPP quality measures.
Reviews and approves data submitted by Medicaid providers or payors participating in quality programs.
Identifies issues with submitted data and works with Medicaid providers to bring reporting in line with state and federal requirements.
Participates in the development of the quality aspects of the DPPs.
Prepares high quality written documents, including guidance documents, presentations, project updates, summaries, legislative reports, memos for executive leadership, and other documents related to QI initiatives.