RAC Operations Specialist

Texas Health & Human Services Commission•Austin, TX

2d•$4,523 - $7,254•Hybrid

About The Position

The Management Analyst II (Recovery Audit Contract (RAC) Operations Specialist) is managed by the RAC Director within the Texas Health and Human Services (HHS) Office of Inspector General (OIG). Performs complex (journey level) professional analytical and operational work. Works under general supervision, with moderate latitude for the use of initiative and independent judgment. Analyzes programmatic and operational data, evaluates processes and procedures, identifies trends and issues, develops data-informed recommendations, and supports implementation of program improvements. Coordinates program-specific activities, reviews RAC vendor work products, resolves provider and stakeholder inquiries, and promotes program efficiency.

Requirements

Graduation from an accredited four-year college or university. Work experience may be substituted for education on a year-for-year basis.
Minimum of 2 years of experience coordinating programmatic or operational work.
Knowledge of: Principles and practices of program administration and operations analysis.
Knowledge of: State and federal laws, rules, and policies related to health and human services.
Knowledge of: The Texas Medicaid program.
Knowledge of: Medicaid claims processing and terminology.
Knowledge of: Methods for collecting, organizing, analyzing, and interpreting quantitative and qualitative data.
Knowledge of: Program evaluation and performance measurement techniques.
Knowledge of: Research methods and techniques.
Knowledge of: Process improvement and organizational effectiveness principles.
Knowledge of: Customer service principles and methods for resolving inquiries and issues.
Knowledge of: Project coordination and stakeholder management practices.
Skill in: Analyzing and interpreting complex data sets; identifying relevant trends, relationships, discrepancies, and issues; and translating findings into actionable recommendations.
Skill in: Identifying operational problems and developing practical solutions.
Skill in: Researching and resolving inquiries.
Skill in: Coordinating activities involving multiple parties.
Skill in: Monitoring contractor work and program deliverables.
Skill in: Preparing clear, concise, accurate, and well-supported written reports and correspondence.
Skill in: Using spreadsheets, databases, reporting tools, and other technology to analyze and present information.
Skill in: Communicating effectively, both verbally and in writing.
Ability to: Exercise independent judgment in analyzing problems and determining appropriate courses of action, including when to escalate issues or seek guidance.
Ability to: Interpret policies, procedures, regulations, and program requirements and apply them to operational situations.
Ability to: Develop evidence-based recommendations to improve program operations and outcomes.
Ability to: Establish and maintain effective working relationships.
Ability to: Organize and manage multiple projects, assignments, and deadlines.
Ability to: Maintain confidentiality and exercise sound judgment when handling sensitive information.

Nice To Haves

Certified Texas Contract Manager (CTCM) or Certified Texas Contract Developer (CTCD) preferred.
Experience working within federal, state, or local, government or a public agency is preferred.

Responsibilities

Collects, organizes, validates, and analyzes programmatic, operational, customer service, and performance data from multiple sources. Uses data gathered to identify trends, patterns, discrepancies, operational issues, risks, and opportunities for improvement as well as to inform programmatic decisions. Develops and maintains spreadsheets, reports, dashboards, tracking tools, and other analytical products to monitor program performance. Conducts research and analysis related to RAC processes and operational issues and communicates findings to management. Evaluates performance measures and identifies areas requiring corrective action, additional resources, or changes in procedures. Prepares analytical reports, presentations, briefing materials, and summaries that translate complex information into actionable recommendations.
Reviews and evaluates program processes, workflows, policies, procedures, and operational practices to assess effectiveness, efficiency, consistency, and compliance with applicable requirements. Identifies operational problems and develops recommendations for improving program processes, customer service, internal controls, and program outcomes. Implements new program procedures, processes, and operational requirements. Monitors program initiative and process change implementation activities, evaluating whether intended results are achieved. Develops and maintains documentation of business processes, workflows, procedures, and operational requirements. Coordinates assigned operational activities and follows up with responsible parties to ensure timely completion. Conducts special projects and operational studies related to assigned programs and agency functions.
Manages a mailbox and responds to or coordinates responses to customer inquiries, requests for information, and program-related issues. Provides accurate, timely, professional, and well-supported written responses to customers. Tracks inquiries, response times, issues, and resolutions to identify recurring questions, trends, and improvement opportunities. Recommends potential changes to processes, communications, or procedures. Escalates complex, sensitive, or unresolved issues to management and assists in developing resolutions.
Coordinates program activities. Serves as a liaison between agency staff and the RAC vendor regarding program requirements, assignments, deliverables, timelines, and operational issues. Coordinates information requests, meetings, work assignments, deliverables, and follow-up activities necessary to accomplish program objectives. Monitors contractor activities and deliverables for timeliness, completeness, accuracy, and compliance with established program requirements. Identifies RAC vendor performance or implementation issues and coordinates resolutions. Collaborates with partners on program-specific activities, including information sharing, implementation efforts, data requests, operational coordination, and issue resolution. Communicates program requirements and operational expectations. Maintains documentation regarding coordination activities, decisions, deliverables, and outstanding issues.
Prepares technical, operational, and program reports summarizing activities, findings, performance measures, issues, alternatives, and recommendations. Develops briefing materials, presentations, correspondence, procedures, guidance documents, and other materials. Maintains accurate documentation of program activities, customer inquiries, operational decisions, contractor activities, and issue resolutions. Develops work plans, schedules, tracking tools, and other mechanisms to monitor program activities and deliverables. Conducts special projects, studies, and evaluations involving program operations, organizational effectiveness, customer service, or process improvement.
Attends work on a regular and predictable schedule in accordance with agency leave policy and performs duties as assigned. Performs other duties necessary to achieve the mission of the OIG. Keeps manager informed as required or as necessary.