Texas Health and Human Services
Overview
Join the Texas Health and Human Services Commission (HHSC) as a Program Specialist VI (Program Coordinator) in the Provider Enrolment (PE) program. The role involves serving as a PE liaison between HHSC, state contractors, and Medicaid providers to perform advanced consultative and technical work related to PE program policies and processes in a dynamic environment. Responsibilities
Researching and interpreting program policies, procedures, rules, regulations, guidance, and standards related to Medicaid provider enrollment. Providing technical assistance to program and PE staff, providers, and State Medicaid contractors. Responding to legislative and external inquiries and requests. Preparing complex written reports; researching and resolving PE-related provider complaints and escalations. Leading special projects. Performing legislative bill analysis. Serving as a liaison and information conduit between PE and Medicaid providers. Essential Job Functions
Provider Support
– Assists the Provider Enrollment unit with PE-related questions and complaints. Works with internal and external stakeholders, including contracted vendors, to research and disposition provider questions and complaints. (25%) Liaison
– Leads or represents PE in workgroups and meetings to disseminate information on PE policy and programmatic initiatives. Prepares agenda, facilitates discussions, and maintains effective working relationships with PE representatives. Coordinates with stakeholders on major initiatives including workgroups, technical changes, policy changes, and other major projects. Coordinates with other HHSC areas involved in managed care. Identifies operational, policy and technical impacts to PEs, shares information with stakeholders and coordinates to ensure successful implementation. Solicits feedback from internal and external stakeholders on proposed program and policy changes. (25%) Technical Support
-Provides technical assistance to program and PE staff, providers, and State Medicaid contractors. Serves as an expert on managed care policies and processes that affect PE; provides consultative support to other PE staff on PE policies and processes. Plans, researches, coordinates PE program policies and rules that affect other HHSC program areas. Recommends PE contract updates for PE. (15%) Research and analysis
– Interprets policies, procedures, rules, regulations and standards related to program to other program areas. Performs legislative bill analysis. Researches PE contracts and processes. (15%) Communications
– Responds to legislative and external inquiries and requests. Prepares complex written reports, presentations and other PE program deliverables. Presents program policy at meetings. Participates in other workgroup meetings. Communicates with industry stakeholder groups such as provider associations and health plan associations. Drafts guidance and notices to providers with program updates. (10%) Special Projects
- Leads and participates in operational projects affecting the unit. Coordinates with other program areas with minimal oversight. Serves as a lead team member providing direction to others. May train others. (10%) Qualifications
Initial Screening Criteria Graduation from an accredited four-year college or university. Relevant work experience may be substituted for educational requirement on a year-for-year basis; Three years’ experience preferred researching, analyzing, developing and communicating policy to stakeholders; and Three years’ experience handling customer escalations. Preferred Two years’ experience preferred working in the healthcare industry; and Three years’ experience preferred leading large workgroups or special projects or hosting webinars or virtual online meetings or events. Additional Information
N/A Active Duty, Military, Reservists, Guardsmen, And Veterans: Military occupation(s) related to the initial selection criteria and registration or licensure requirements may include, but are not limited to those listed in this posting. All active-duty personnel are encouraged to apply if qualified. ADA Accommodations: HHSC and DSHS agencies will provide reasonable accommodation during the hiring process for qualified individuals with a disability. If you need assistance completing the online application, contact the HHS Employee Service Center. If you are interviewed and need accommodation to participate, please notify the interviewer. Pre-Employment Checks And Work Eligibility: Depending on the program area and position requirements, applicants may be required to pass background and other checks. HHSC uses E-Verify. Bring your I-9 documentation on your first day of work. Telework Disclaimer: This position may be eligible for telework. Telework is subject to state and agency policies and the discretion of the supervisor and business needs. Nearest Major Market: Austin
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Join the Texas Health and Human Services Commission (HHSC) as a Program Specialist VI (Program Coordinator) in the Provider Enrolment (PE) program. The role involves serving as a PE liaison between HHSC, state contractors, and Medicaid providers to perform advanced consultative and technical work related to PE program policies and processes in a dynamic environment. Responsibilities
Researching and interpreting program policies, procedures, rules, regulations, guidance, and standards related to Medicaid provider enrollment. Providing technical assistance to program and PE staff, providers, and State Medicaid contractors. Responding to legislative and external inquiries and requests. Preparing complex written reports; researching and resolving PE-related provider complaints and escalations. Leading special projects. Performing legislative bill analysis. Serving as a liaison and information conduit between PE and Medicaid providers. Essential Job Functions
Provider Support
– Assists the Provider Enrollment unit with PE-related questions and complaints. Works with internal and external stakeholders, including contracted vendors, to research and disposition provider questions and complaints. (25%) Liaison
– Leads or represents PE in workgroups and meetings to disseminate information on PE policy and programmatic initiatives. Prepares agenda, facilitates discussions, and maintains effective working relationships with PE representatives. Coordinates with stakeholders on major initiatives including workgroups, technical changes, policy changes, and other major projects. Coordinates with other HHSC areas involved in managed care. Identifies operational, policy and technical impacts to PEs, shares information with stakeholders and coordinates to ensure successful implementation. Solicits feedback from internal and external stakeholders on proposed program and policy changes. (25%) Technical Support
-Provides technical assistance to program and PE staff, providers, and State Medicaid contractors. Serves as an expert on managed care policies and processes that affect PE; provides consultative support to other PE staff on PE policies and processes. Plans, researches, coordinates PE program policies and rules that affect other HHSC program areas. Recommends PE contract updates for PE. (15%) Research and analysis
– Interprets policies, procedures, rules, regulations and standards related to program to other program areas. Performs legislative bill analysis. Researches PE contracts and processes. (15%) Communications
– Responds to legislative and external inquiries and requests. Prepares complex written reports, presentations and other PE program deliverables. Presents program policy at meetings. Participates in other workgroup meetings. Communicates with industry stakeholder groups such as provider associations and health plan associations. Drafts guidance and notices to providers with program updates. (10%) Special Projects
- Leads and participates in operational projects affecting the unit. Coordinates with other program areas with minimal oversight. Serves as a lead team member providing direction to others. May train others. (10%) Qualifications
Initial Screening Criteria Graduation from an accredited four-year college or university. Relevant work experience may be substituted for educational requirement on a year-for-year basis; Three years’ experience preferred researching, analyzing, developing and communicating policy to stakeholders; and Three years’ experience handling customer escalations. Preferred Two years’ experience preferred working in the healthcare industry; and Three years’ experience preferred leading large workgroups or special projects or hosting webinars or virtual online meetings or events. Additional Information
N/A Active Duty, Military, Reservists, Guardsmen, And Veterans: Military occupation(s) related to the initial selection criteria and registration or licensure requirements may include, but are not limited to those listed in this posting. All active-duty personnel are encouraged to apply if qualified. ADA Accommodations: HHSC and DSHS agencies will provide reasonable accommodation during the hiring process for qualified individuals with a disability. If you need assistance completing the online application, contact the HHS Employee Service Center. If you are interviewed and need accommodation to participate, please notify the interviewer. Pre-Employment Checks And Work Eligibility: Depending on the program area and position requirements, applicants may be required to pass background and other checks. HHSC uses E-Verify. Bring your I-9 documentation on your first day of work. Telework Disclaimer: This position may be eligible for telework. Telework is subject to state and agency policies and the discretion of the supervisor and business needs. Nearest Major Market: Austin
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