TF Investigation Lead
About The Position
The HHSC Long Term Care Regulation Trust Fund Auditor III (TFA III) serves as Investigation Lead (IL) for the LTCR Trust Fund Monitoring Unit. The Investigation Lead is primarily responsible for the oversight of the financial complaint investigation function of the unit. The IL is responsible for implementing goals and objectives, developing team priorities and achieving established team performance measures. The Investigation Lead works under limited supervision of the Trust Fund Unit Manager, with considerable latitude for the use of initiative and independent judgment. The TFA III also works in conjunction with the Trust Fund Field Coordinator, providing leadership and support to the TFMU. This is a mobile worker position and requires travel throughout the State to perform or assist with investigations. Financial investigations involve examining financial records, transactions, statements and business practices to ensure compliance with state and federal statutes and regulations. The process identifies any deficient practices, determines appropriate corrective actions, and provides follow-up to assure corrective actions are implemented. The process may also recommend punitive measures if corrective actions are not completed by the contractor. It may also result in the need to provide testimony at formal or informal hearings. Results of the investigation process may also advise contractors on the requirements, liabilities, and penalties of compliance and noncompliance; provide technical assistance; and recommend improved accounting and/or management practices. The TFA III may coordinate work with the Texas Attorney General's office, (OAG) the Texas Inspector General's office (IG)as well as other HHSC Regulatory Services units. The TFA III Investigation Lead must provide high quality customer service to external and internal customers by providing prompt responses to inquiries, taking the initiative to solve problems, exercising flexibility, and continuing to seek improvements within the unit. May travel up to 50% with some overnight trips. Attends work on a regular and predictable schedule in accordance with agency leave policy and performs other duties as assigned.
Requirements
- Knowledge of HHS Trust Fund Monitor (TFM)
- Knowledge of Accounting practices and principals
- Knowledge of the investigation process
- Eligibility requirements for Medicaid for the Elderly and Persons with Disabilities (MEPD)
- Knowledge and understanding of applied income calculations and guidelines
- Knowledge of Medicaid, Medicare, and private insurance reimbursement methodologies
- Ability to access and interpret data in state systems: Provider; TIERS; SharePoint; NeuDocs; HHS Portal and PS Win
- Ability to work independently and solve problems
- Ability to present information both oral and in writing
- Ability to travel up to 50%
- Ability to multi-task; set priorities and goals
- Ability to maintain a rigorous work/travel schedule
- Ability to use Word and Excel
- Valid Texas driver's license
Nice To Haves
- Graduation from an accredited four-year college or university with major course work in business, accounting or a related field is generally preferred. Experience and education may be substituted for another on a year for year basis.
Responsibilities
- Triage incoming complaint intakes and assign priority level
- Assign intakes to investigators in a fair and equitable way
- Provide assistance to investigators during the investigation process
- Train and support team members on use of the investigation tools
- Monitor progress of open investigations
- Assure that deadlines are met
- Review and approve final investigation reports
- Travel to perform, assist with/observe investigation process
Benefits
- 100% paid employee health insurance for full-time eligible employees
- A defined benefit pension plan
- Generous time off benefits
- Numerous opportunities for career advancement
- Qualifying organization for the Federal Public Service Loan Forgiveness Program
- Excellent health benefits
- A lifetime monthly retirement annuity
- 401(k) and 457 Programs under the Employees Retirement System of Texas
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
