Program Specialist III
1 month ago
Medicaid and CHIP Services (MCS) at the Texas Health and Human Services Commission (HHSC) seeks a highly qualified candidate to fill the position of Program Specialist III. MCS is driven by its mission to deliver quality, cost-effective services to Texans. This position makes a significant contribution to MCS’s mission by providing moderately complex consultative and technical assistance for the Intellectual and Developmental Disabilities Program Eligibility and Support (IDD PES) unit. The Program Specialist III reports to the Unit Manager within IDD PES.
The IDD PES team is responsible for ensuring eligible Texans are enrolled in programs serving individuals with intellectual and/or developmental disabilities. These programs include Home and Community-based Services (HCS), Texas Home Living (TxHmL), Community Living Assistance and Support Services (CLASS), the Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Condition (ICF/IID), and Community First Choice Non-Waiver (CFC NW). IDD PES staff authorize and verify programmatic eligibility for the listed programs. In addition, IDD PES staff process enrollments, transfers, suspensions, and terminations for HCS, TxHmL, and CLASS and coordinate and attend Fair Hearings.
Work involves the review and processing of enrollments, transfers, terminations, and suspensions for the HCS and TxHmL programs. Work also involves monitoring enrollment activities, such as Individual Plans of Care (IPC) and Level of Care/Level of Need (LOC/LON) determinations. This position coordinates with the local IDD authorities (LIDDAs) to monitor individuals whose services have been suspended and serves as a liaison with Medicaid for the Elderly and Persons with Disabilities (MEPD) to verify financial eligibility (Medicaid) for the program. Work also involves monitoring provider and LIDDA inquiries and ensures timely resolutions. Conducts analysis of data and reports as assigned, and collects, organizes, analyzes and prepares materials in response to requests for program information or fair hearings. Assists in creating presentation material, organizing documents and may present program rules, policy and procedure information to internal and/or external stakeholders. Works under general supervision with moderate latitude for the use of initiative and independent judgment.
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.
Essential Job Functions:
Attends work on a regular and predictable schedule in accordance with agency leave policy and performs other duties as assigned.
(35%) Reviews and processes enrollments, transfers, terminations, and suspensions for the HCS and TxHmL programs using various electronic database systems.
(25%) Provides moderately complex consultative and technical assistance, including research, assessment and planning directly to management, HHSC staff, LIDDA staff, program providers, program participants and their families.
(15%) Monitor provider and LIDDA inquires by managing multiple spreadsheets and navigating various electronic database systems.
(10%) Develops recurring reports and conducts data analysis in accordance with program objectives and goals.
(10%) Assists in creating presentation material, organizing documents and may present program rules, policy and procedure information to internal and/or external stakeholders.
(5%) Serves as agency representative in fair hearings.
Knowledge Skills Abilities:
•Knowledge of Medicaid wavier programs (such as HCS, TxHmL, or ICF/IID).
•Knowledge of federal and state laws relating to long term care and/or other Medicaid and non-Medicaid services and programs.
•Knowledge of program planning, evaluation, and implementation.
•Skilled in organization and prioritization.
•Ability to communicate effectively, both orally and in writing.
•Ability to understand and follow policies and procedures.
•Ability to maintain accurate files, records, and databases.
•Ability to gather, assemble, correlate, and analyze information.
•Ability to operate computers and experience using Microsoft Office products.
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