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Program Specialist VI

3 months ago

Austin, United States Texas Department of Aging & Disability Services Full time
Job Description:
The Texas Health and Human Services Commission (HHSC) Medicaid CHIP Services (MCS) department seeks a highly qualified candidate to fill the position of Program Specialist VI in Managed Care Contracts and Oversight (MCCO). MCS is driven by its mission to deliver quality, cost-effective services to Texans. The Program Specialist VI makes a significant contribution to MCS’s mission by ensuring that managed care organizations (MCO) and dental maintenance organizations (DMO) have a choice of network providers for members to receive timely access to necessary services. The position reports to the Director of Strategic Operations and Special Projects within MCCO.

This position conducts research and analysis of highly complex information, reports and data for projects and initiatives, writes reports by utilizing qualitative and quantitative data to draw conclusions and recommendations, provides consultative services and technical assistance, prepares management responses, and reports with analysis, and appropriate project prioritization. This position will work under minimal supervision with considerable latitude for the use of initiative and independent judgment. Essential Job Functions:
The Program Specialist VI performs advanced analysis including cross-divisional collaboration with planning, developing, and implementing major agency programs and providing consultative services and technical assistance to program staff, governmental agencies, community organizations, or the public. Oversees compliance with contract standards, policies, procedures, and processes. Monitors performance of MCOs and DMOs related to network adequacy to ensure contract compliance of key performance requirements. (20%)

Creates reports by building, configuring, consolidating, organizing, formatting, and summarizing data into informational summary reports used to analyze policy, programs, and operations. Collects, organizes, analyzes, and prepares written materials in response to requests for program information and data reports. Conducts analysis by questioning, examining, interpreting, comparing, and confirming data and reports to extract meaningful insights used to understand and improve business performance. (30%)

Develops policies, guidelines, and operating procedures for the unit, and communications for stakeholders. (15%)

Participates in functions related to operational reviews, webinars, desk reviews, readiness reviews, implementations, information sessions or other activities, as required. Reviews, analyzes, and evaluates legislation, rules, bills, and federal/state laws, policies, procedures, and guidelines with implications for the Medicaid and CHIP programs and develops recommendations for policy and programmatic issues relating to the operation, implementation, improvement, and/or expansion or reduction to the program. Participates in the development of RFPs and the evaluation of RFP responses within assigned timeframes. Assists with legislative, open records, and audit requests within specified timeframes. (10%)

Establishes and maintains effective working relationships and communication with staff from other agencies and organizations, appropriately interacts with others, and provides timely responses to requests and inquiries. Represents MCCO in a positive manner. Demonstrates commitment to the goals of the Medicaid/CHIP services, shows initiative to take on new projects, is team-oriented and committed to outstanding customer service, and focuses on promoting efficiencies and accountability. (10%)

Works constructively with the team and leadership to address problematic situations and applies proper judgment to ensure action taken is appropriate. Attends work on a regular and predictable schedule in accordance with agency leave policy. May train others. (10%)

Prepares administrative data reports and analysis and performs specialized research projects. Other duties as assigned or required. (5%)
Knowledge Skills Abilities:
Knowledge of federal laws, regulations, and processes regarding Medicaid and CHIP preferred.

Ability to work under limited supervision with considerable latitude to use of initiative and independent judgment.

Ability to gather, assemble, correlate, and analyze facts, devise solutions to problems, conduct sophisticated research, prepare reports, develop, evaluate, and interpret policies, procedures and contract requirements.

Ability to communicate effectively, orally or written, including the ability to develop and make public presentations and write technical information in an understandable format, produce sophisticated research and analytical reports.

Ability to establish and maintain effective working relationships with managers, co-workers, other agency personnel and the public.

Ability to work individually and as a team in a fast-paced, deadline orientated environment.

Ability to think clearly using effective critical thinking skills.