Quality Management Specialist

TX-HHSC-DSHS-DFPS•Austin, TX

2d•$4,523 - $7,254•Hybrid

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. This position is telework eligible. Please note, all HHS positions are subject to state and agency telework policies in addition to the discretion of the direct supervisor and business need.

Requirements

Bachelor's Degree with major course work in human service from a U.S. accredited college, university, or foreign degree determined to be equivalent by an acceptable education evaluator.
Relevant experience may be substituted for education on a year-to-year basis.
Knowledge of the application of the principles of quality management for improvement of substance abuse services
Knowledge of state, and federal laws, agency regulations, policies, rules and requirements pertaining to the provision of substance abuse services in the community
Knowledge of laws and rules applicable to confidentiality and the management of protected health information
Knowledge of data systems for managing operations and making decisions
Skill in effective verbal communication and public speaking, and interpretation and presentation of complex data sets and analysis
Skill in project management with complex projects that cross agencies and several lines of business
Skill in identifying problems, evaluating alternatives, and negotiating and implementing solutions to organizational and service delivery problems
Skill in advanced business and technical writing, data analysis, reporting, and interpretation of complex data sets related to provider performance
Ability to organize and present information effectively, both orally and in writing
Ability to analyze and solve work problems affecting the operations and functions
Ability to provide information to providers regarding areas of non-compliance and less than acceptable quality in an informative non-threatening manner
Ability to plan, organize and manage large multi-faceted projects and work in collaboration with others to manage multiple deadlines
Ability to plan, assign and manage the work of others

Nice To Haves

Knowledge of Medicaid managed care programs, policies, procedures, contracts, and service delivery mechanisms desired but not required.

Responsibilities

Plans, implements and functions as Review leader for onsite, desk, focused and statewide reviews to assess service quality and compliance with Mental Health and/or Substance Use Disorder contracts, grants, applicable Federal and state laws, regulations, policies, and procedures; and prepares the required reports or responses as appropriate.
Maintains positive work relationships with internal and external stakeholders.
Evaluates organizational systems, business functions and the quality and efficacy of services.
Evaluates plans of correction/improvement, and conducts follow-up to determine if improvements have been made and are maintained, and works with contract manager/project officer to recommend sanctions and penalties.
Develops and implements policy and protocols for evaluation of business functions, service delivery and outcomes; employs quality management methods to collect, synthesize, analyze and use data in the process of facilitating continuous improvement within organizations providing Mental Health and/or Substance Use Disorder services.
Conducts studies and specialized research projects, represents Quality Management Unit on work groups to develop standards and processes for new agency initiatives within a team model.
Participates in activities such as risk assessment to determine priorities for the deployment of oversight resources; performs analysis and interpretation of data to identify trends and best practices.
Uses data and knowledge of the system to make recommendations to management and providers to improve the quality or efficiency of processes.
Participates in performance measurement and identification of providers at risk of non-compliance with the contract or delivering poor quality Mental Health or Substance Use Disorder services.
Ensures communication of findings to Mental Health and Substance Use Disorder providers during review exits and technical assistance.
Produces professional communications including but not limited to letters, technical reports, executive summaries, charts, graphs, minutes, memos, e-mails, slide show presentations.
Responds appropriately to queries from the field, the public and within the agency and complaints regarding Mental Health and Substance Use Disorder programmatic compliance.
Provides consultation and technical assistance related to quality management, increasing compliance and effective oversight of contracts to managers, staff, LMHAs, providers and stakeholders maintaining positive work relationships with internal and external stakeholders.
Provides training for QM staff and others within the agency, providers and members of the community in compliance, quality improvement, identification of best practices and the development of new methods and procedures.
Identifies methods to improve processes and the efficiency of unit activities.
Participates in evaluations of inter rater-reliability to ensure accurate and consistent findings.
Plans, assigns, guides and oversees the work of QM staff when functioning as a project manager or team leader and is responsible for the efficient and effective deployment of resources within the team model.