HCS/TxHmL/ICF Program Advisor

The Texas Health and Human Services Commission (HHSC) Medicaid CHIP Services (MCS) division seeks a highly qualified candidate to fill the position of Program Specialist IV. MCS is driven by its mission to deliver quality, cost-effective services to Texans. This position makes a significant contribution to MCS’s mission by providing highly complex consultative and technical assistance for the Intellectual and Developmental Disabilities Program Eligibility and Support (IDD PES) unit.  

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.  The Program Specialist IV reports to the Unit Manager within IDD PES and works as a team member to support unit functions.  

The IDD PES team is responsible for ensuring eligible Texans are enrolled in programs serving individuals with intellectual and/or developmental disabilities. These programs include: Home and Community-based Services (HCS), Texas Home Living (TxHmL), Community Living Assistance and Support Services (CLASS), the Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Condition (ICF/IID), and Community First Choice Non-Waiver (CFC NW). IDD PES staff authorize and verify programmatic eligibility for the listed programs. In addition, IDD PES staff process enrollments, transfers, suspensions, and terminations for HCS, TxHmL, and CLASS and coordinate and attend Fair Hearings. 

Work involves the review and processing of enrollments, transfers, terminations, and suspensions for the HCS and TxHmL programs. Work also involves monitoring enrollment activities, such as Individual Plans of Care (IPC) and Level of Care/Level of Need (LOC/LON) determinations. Routinely reviews and analyzes HCS and TxHmL program activity data to assess the need for additional oversight. Work also involves monitoring provider and LIDDA inquiries and ensures timely resolutions. Evaluates enrollment IPC and eligibility activities and trends to resolve technical problems, identify opportunities for improvement, and to make recommendations for improvements in review processes. Conducts analysis of data and reports as assigned, and collects, organizes, analyzes and prepares materials in response to requests for program information, or special project reports. Develops and revises review tools (e.g., review protocols, evaluation forms, etc.) in accordance with program objectives and goals. Will serve as the lead to prioritize the work of colleagues by assigning provider deliverables to designated unit staff in absence of the HCS/TxHmL/ICF Unit Manager. Conducts training and provides guidance to staff in the development or integration of new or revised operational procedures. Coordinates and collaborates with program staff through participation in unit and cross-agency workgroups related to unit functions and planning to analyze, develop, and implement program initiatives. Works under limited supervision with moderate latitude for the use of initiative and independent judgment. 

Essential Job Functions: 

Works collaboratively across MCS to identify innovative and effective solutions. Attends work on a regular and predictable schedule in accordance with agency leave policy and performs other duties as assigned.  
 
(30%) Provides highly complex consultative and technical assistance, including research, assessment and planning directly to management, HHSC program staff, HHSC contract management staff, LIDDA staff, the program provider base, advocacy groups, stakeholders, program participants and their families.  

(25%) Conducts analysis of data and reports as assigned, and collects, organizes, analyzes, and prepares materials in response to requests for program information, or special project reports.  
 
 

(15%) Coordinates and collaborates with program staff through participation in unit and cross-agency workgroups related to unit functions and planning to analyze, develop, and implement program initiatives.   
 
 

(10%) Develops and revises review tools (e.g., review protocols, evaluation forms, etc.) in accordance with program objectives and goals.   
 
 

(10%) Conducts training and provides guidance to staff in the development or integration of new or revised operational procedures.