Program Specialist V
1 month ago
The Delivery System Quality & Innovation (DSQI) Unit within the Medicaid CHIP Services (MCS) Office of Quality and Program Improvement seeks a highly qualified candidate to fill the position of Quality Analyst (Program Specialist V). The mission of DSQI is to incentivize, innovate, and educate to improve health care quality. The DSQI Unit develops and implements innovative requirements and financial incentives, provides education & technical assistance to increase the adoption of best practices, and evaluates the effectiveness of quality programs & interventions.
The Quality Analyst is selected by and directly reports to the Manager V in the Delivery System Quality & Innovation (DSQI) Unit. The Quality Analyst works under general direction with extensive latitude for the use of initiative and independent judgment. Responsibilities include developing written communication and presentations for internal and external stakeholders; providing and coordinating technical assistance to program participants; and completing research, analysis, and development activities concerning major programs impacting HHSC and other Texas HHS agencies.
The DSQI team currently leads multiple high profile quality improvement initiatives that are critical to the Medicaid program in Texas, such as the quality aspects of Medicaid directed payment programs, the Non-Medical Drivers of Health (NMDOH) Action Plan, and working with hospitals to reduce unnecessary emergency department utilization by people with Medicaid. The Quality Analyst will work collaboratively as part of a team, and also serve as a lead point of contact on DSQI quality initiatives.
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:
Works collaboratively across MCS to identify innovative and effective solutions for clients and staff.
(35%) Prepares high quality written documents, including guidance documents, presentations, project updates, summaries, legislative reports, memos for executive leadership, and other documents relating to quality improvement and innovation initiatives.
(20%) Works with and presents to Medicaid providers as well as provider associations to coordinate, improve, and secure support for quality and innovation initiatives. Consults with HHSC staff and stakeholders to resolve problems, identify training needs and discuss program effectiveness.
(20%) Reviews and approves data submitted by Medicaid payors and Medicaid providers participating in quality programs. Identifies issues with submitted data and works with Medicaid providers to develop corrective action plans and bring reporting in line with state and federal requirements.
(15%) Conducts policy research, data analysis, spreadsheet development and maintenance, and coordination related to reporting of healthcare quality measures, as well as other Medicaid quality or delivery system reform planning and implementation activities.
(10%) Contributes to the development of program and policy options for Medicaid quality programs and initiatives, including options, timelines, analyses, and detailed work plans. Assist in the development of monitoring and evaluation plans for quality improvement initiatives including state directed payment programs. Knowledge Skills Abilities:
• A keen attention to detail.
• Strong skills in communicating effectively both orally and in writing.
• Knowledge of federal and state Medicaid and CHIP programs, services, and requirements.
• Familiarity with key concepts of delivery system reform, healthcare innovation, non-medical drivers of health, alternative payments models, or population health.
• Familiarity with healthcare quality measurement and common data sources used for healthcare monitoring and evaluation.
• Skill in synthesizing, analyzing, and evaluating complicated and technical information and translating it into easily understandable and concise documents and oral presentations.
• Skill in project management.
• Skills in conducting policy and data analysis, as well as performing research.
• Skill in developing creative and workable solutions to complex problems and policy issues.
• Ability to negotiate with multiple parties, internally across an organization and externally with stakeholders, resolve conflicts, and establish and maintain effective working relationships.
• Ability to exercise judgment and work independently with minimum supervision.
• Ability to lead and work cooperatively in a team environment.
• Ability to use word-processing and spreadsheet applications in a windows environment.
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