Medical Policy Manager

2 days ago

Austin, Texas, United States Texas Department of Aging & Disability Services Full time
Job Title: Medical Benefits Policy Manager

The Medical Benefits Policy Manager plays a critical role in the development of clinical policy for Texas Medicaid medical benefits. This position reports to the Director of Medical and Dental Benefits Policy and is responsible for administering daily operations and activities related to policy development.

Key Responsibilities:
  • Plans, assigns, and supervises the work of staff in the development of medical policy.
  • Provides direction to staff for the development of medical policy to ensure that tasks are performed using established, evidence-based resources, processes, and time frames.
  • Reviews and approves all work product.
  • Facilitates communication within the Office of Policy and Program, Office of Medical Director, and other areas within HHS and other agencies.
  • Assists with negotiations and problem-solving to ensure quality of work and that work is performed within time frames.
  • Identifies areas of needed change and makes recommendations to improve operations.
  • Ensures staff is trained to complete assigned work, and expectations of staff are clearly and respectfully communicated.
  • Motivates staff through positive and constructive feedback, fostering professional development, collaboration among and between teams, and promoting constructive interpersonal communication within their team.
  • Communicates with staff regarding work performance and expectations.
  • Assists staff in constructively and productively dealing with change, as appropriate.
  • Establishes goals and standards for the team and develops measurement tools for determining progress for meeting goals/standards.
  • Performs human resource requirements including approval of time and leave, recruiting potential staff, interviewing, hiring, and advising staff.
  • Leads or participates in agency workgroups as necessary for successful implementation of projects, policies, and initiatives.
  • Works with and speaks to community and professional groups, other HHSC programs, other state agencies, legislative staff, and public stakeholders, to provide information, technical assistance, identify needs, cultivate professional relationships, and resolve issues.
  • Makes presentations with recommendations to executive staff and other leaders.
  • Approves staff responses to legislative, provider, and stakeholder requests for information.
Requirements:
  • Knowledge of the Medicaid and CHIP programs, as well as other public health services programs.
  • Knowledge of public administration and management techniques.
  • Knowledge of analysis processes and program planning and implementation.
  • Skills in researching clinical, scholarly, academic, and peer-reviewed literature.
  • Skills in assembling and analyzing facts to devise solutions to problems.
  • Skills in written and oral communication, including the ability to make public presentations, write technical information in an understandable format, and produce sophisticated research reports.
  • Skills in developing and evaluating policies and procedures.
  • Skills in managing competing priorities and establishing and maintaining effective working relationships.
  • Ability to communicate effectively, lead and motivate staff, lead project teams, and work with multiple stakeholders, setting clear and collaborative goals and expectations with their staff and co-workers.
  • Ability to apply a coaching management style, including active listening, asking questions, providing constructive/collaborative feedback, building trust, and setting SMART goals.
  • Ability to identify problems, evaluate alternatives, and propose effective solutions.
  • Ability to effectively plan, assign, and supervise the work of others.
  • Ability to work cooperatively as a team member in a rapid-paced, deadline-oriented environment.
  • Ability to organize resources to achieve desired outcomes.

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