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License & Permit Specialist IV
4 months ago
Under the direct supervision of the unit manager. Reviews and evaluates complex applications/forms/requests for providers who are applying for licensure, Medicaid and Medicare certification. Responsible for review of all documentation for accuracy. Review, process, and determine facilities eligibility by reviewing applications. Interprets and communicates state and federal rules and regulations to providers. Essential Job Functions:
Application Processing: Conducts complex review of licensure application and supporting documentation and assigns deficiencies for program applications. Drafts, edits, tracks and evaluates deficiency letters and responses. Reviews and evaluates forms, fee payments, technical data, and associated records related to licensure applications for accuracy and completeness. Coordinates license and survey processes with HHSC regional offices.
Reviews and interprets on-site survey findings to determine if applicants are in compliance with program health and safety license eligibility requirements. Based on review and evaluation, makes final determination to approve or deny license applications. Issues state licenses. (50%)
Certification Processing: Conducts quality review of Medicare enrollment forms submitted by applicants for accuracy and completeness. Works with intermediates to providers seeking enrollment in the Medicare program. Prepares certification documents and submits actions for approval by CMS. Reviews accreditation documentation, as required. (5%) Database Management: Ensures critical information into various systems to facility licensure. Maintains and updates application and license data in the Texas Unified Licensure Information Portal (TULIP). (15%)
Customer Service: Interprets and communicates licensing requirements to internal and external stakeholders, orally and in writing. Provides highly complex technical assistance and consultation regarding program requirements and resolves customer concerns. Provides rule and policy interpretation to applicants, their representatives, and the general public. Provides oral and written customer service, answers program rule and policy questions, and provides information relative to the licensure and processing. Performs unit telephone coverage through the provider licensure and certification call center. (15%)
Court Testimony: Testify in court related to the licensure and certification process as needed. (5%)
Other Duties as Assigned: Performs other duties as assigned in order to ensure services are provided. Willingly completes other duties as assigned within time frames and minimum standards established by supervisor at the time of the assignments. Obtains supervisor clarification and assistance as needed to complete task. (10%) Knowledge Skills Abilities:
Knowledge of state and federal laws and regulations related to Long-term Care HHSC programs, preferred.
Skill in analyzing and interpreting complex federal and state regulations, legislation, program policies and procedures.
Skill in problem solving and conflict resolution Skill in providing customer service
Skill in use of Microsoft Office.
Knowledge Skills Abilities: Knowledge of state and federal laws and regulations related to Long-term Care HHSC programs, preferred.
Skill in analyzing and interpreting complex federal and state regulations, legislation, program policies and procedures.
Skill in problem solving and conflict resolution Skill in providing customer service
Skill in use of Microsoft Office.
Ability to prioritize workload with little or no supervision.
Ability to work well with others, including establishing and maintaining effective relationships Ability to work under pressure in a fast-paced, deadline-oriented environment.
Ability to effectively communicate, organize and present information with others orally and in writing.
