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Program Specialist V Recovery Management Liaison
4 months ago
Works under the HHSC Special Projects Unit manager or designee with latitude for the use of initiative and independent judgment. Performs advanced (senior-level) consultative services and technical assistance work. Specialist functions as part of a team of staff designated to work on oversight and management of Home and Community-Based Services—Adult Mental Health Program (HCBS-AMH) Medicaid (i) programs for individuals with serious mental illness (SMI). The HCBS-AMH program provides services that support the individual in the community, without which the individual demonstrates an increased risk for institutionalization. Specialist will perform advanced (senior-level) consultative services and technical assistance work that involves working with community-based providers. Duties include: contract monitoring, developing statements of work, billing activities, policy and procedure development, program education for potential providers, technical assistance for program providers, clinical oversight, service delivery oversight, quality management activities and utilization management, data analysis, and program evaluation. Specialist will work closely with HHSC Quality Management and Decision Support Units, Contract Management Unit and Centers for Medicare and Medicaid Services (CMS) to ensure compliance with the HCBS-AMH program and provider contract requirements, develop and implement program goals and objectives, and ensure project course corrections when needed. Works closely with contracted providers contracted to provide HCBS-AMH program services to resolve problems and discuss program effectiveness. Essential Job Functions:
1.Provides complex consultative services, coordination and technical assistance related to billing and contract oversight. Plan to implement, and monitor HCBS programs. Works closely with community-based providers and local mental health authorities. Monitors provider contracts. Works closely with Contract Management Unit to develop statements of work for providers. (25%)
2.Develops and updates program policies and procedures related to implementation and monitoring of HCBS-AMH program services. Develops and updates program billing guidelines. Ensures that community based providers receive training on new policies procedures and guidelines and conducts periodic monitoring to ensure compliance. (25%)
3.Assists with HCBS-AMH participants recovery plans and eligibility reviews to authorize services and verify eligibility with HCBS-AMH program requirements. (15%)
4.Conducts and coordinates quality management desk and onsite reviews to determine compliance with HCBS program requirements, laws, regulations, policies, and procedures. Analyzes reviews of HCBS-AMH program services and develops action plans to improve effectiveness, if needed. Communicates those findings, orally and in writing, to a wide variety of audiences, including from DSHS, HHSC, and CMS. (10%)
5.Participates in quality monitoring program to ensure that identified problems are acted upon and resolved promptly. Works with team members to determine when course corrections are required when program or program provider is not achieving goals or objectives. (10%)
6.Collects, organizes, analyzes, and prepares material in response to requests for information. Synthesizes complex information for presentation to a wide variety of groups, orally and in writing. These groups consist of DSHS leadership, HHSC leadership, CMS and various stakeholders. (5%)
7.Determines trends and resolves operational problems, within HHSC and within contracted community provider organizations. These consist of service delivery issues, data collection/submission issues, data entry issues, data analysis issues, invoicing processing issues (by providers), invoice processing issues (by HHSC) . (10%)
Knowledge Skills Abilities:
Knowledge of local, state, and federal laws related to Medicaid and HCBS
Knowledge of public administration and management techniques
Knowledge of research techniques; of training techniques; and of program management processes and techniques.
Knowledge of adult mental health issues and services.
Knowledge of recovery, resilience, and mental health promotion.
Skill in identifying measures or indicators of program performance and in operating computers and applicable software.
Skill in verbal communication and public speaking.
Skill in data analysis and reporting, and qualitative interpretation of complex policy issues.
Ability to gather, assemble, correlate, and analyze facts and prepare reports.
Ability to identify and devise solutions to problems
Ability to market programs.
Ability to develop, evaluate, and interpret policies and procedures
Ability to create and monitor budgets.
Ability to communicate effectively verbally and in writing
Ability and to train, lead, and prioritize staff workloads.
Ability to identify problems, evaluate alternatives, and implement solutions to complex policy and implementation issues
Ability to perform mental health assessments
