Manager V

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The Texas Health and Human Services Commission (HHSC) Medicaid CHIP Services (MCS) department seeks a highly qualified candidate to fill the position of Manager V. 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 oversight and monitoring of provider requirements with Individual Plans of Care (IPC) determinations.

Under supervision of the Director for IDD Waivers Utilization Review (UR) Unit, of the Health and Human Service Commission (HHSC), the Manager V serves as a supervising team lead. The position manages the daily workflow for unit staff and coordinates unit activities to ensure program deliverables occur within prescribed timeframes for the Home and Community-based Services (HCS), the Texas Home Living (TxHmL), Community Living Assistance and Support Services (CLASS), and Deaf Blind with Multiple Disabilities (DBMD) waivers. Responsibilities include performance and management of the following: developing and monitoring unit procedures, representing HHSC in fair hearings, participating in monthly Local Intellectual and Developmental Disability Authority or policy webinars, responding to legislative, ombudsman and other external inquiries, developing and revising program manual content, monitoring Medicaid eligibility for individuals in the programs, implementing service plan changes, monitoring service delivery data, performing quality oversight activities of unit processs with the unit manager, and other activities as assigned. The Manager V will routinely represent the Utilization Review unit in meetings with stakeholders, other HHSC departments and/or HHS agency employees.

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 Manager V provides complex consultative and technical assistance directly to management, executive management, HHSC program staff, HHSC contract management staff, local authority (LA) staff, the Home and Community-based Services (HCS), Texas Home Living (TxHmL), Community Living Assistance and Support Services (CLASS), Deaf Blind with Multiple Disabilities (DBMD) and Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID) provider base, advocacy groups, stakeholders, program participants and their families. Work involves supervision of Administrative Support, Program Specialists and nurses in the unit. The Manager V routinely provides consultation and guidance to unit staff regarding program policy and processes. Conducts analysis of data and reports to HHSC UR staff as assigned. Conducts desk reviews to determine compliance with HHSC rules, policies and procedures related to Individual Plans of Care (IPC). Conducts utilization review of proposed and concurrent IPCs. Develops and revises review tools (e.g., review protocols, evaluation forms, etc.). Reviews, monitors and evaluates provider deliverables (e.g., IPCs, LOCs/LONs, LON Increases, ID/RCs, etc.). Develops training curriculum and serves as a training resource.  Reviews and evaluates information on service delivery system methods, outputs and activities in order to identify gaps in resources and recommend improvements of process, electronic systems, rule, or any other job-related task. Participates in unit and cross-agency workgroups related to unit functions and planning. Works under limited supervision with considerable latitude for the use of initiative and independent judgment.
 

Essential Job Functions:

Conducts routine monitoring and analysis of unit deliverables related to utilization review activities (30%).

Directly supervises, trains and supports Administrative staff, Program Specialists, and Nurses. (25%).

Provides consultative services and technical assistance on a complex level to management, program staff, HHSC staff, LA staff and other stakeholders as well as to other governmental agencies, community organizations and the general public. (10%).

 
Testifies and supports reviewers in testifying in scheduled fair hearings and administrative reviews requested by the program participant or legally authorized representative regarding changes in service provision (10%).

Participates in unit and cross-agency workgroups related to provider/ case manager /LA performance, functions and planning (10%).

Maintains repositories of process outcomes and other work products producing scheduled written summations of that information when requested (5%).

Produces well written reports (5%).

Develops and provides training curriculum on the scope of unit services when scheduled to do so (5%). 

Attends work on a regular and predictable schedule in accordance with agency leave policy and performs other duties as assigned.  

Registrations, Licensure Requirements or Certifications:

Qualification as a Qualified Intellectual Disability Professional (QIDP) as defined in 42 Code of Federal Regulations 483.430(a) required.

Knowledge Skills Abilities:

Minimum four years’ experience with individuals with intellectual/development disabilities or related conditions.

Minimum of two years’ experience supervising or managing a department.

Thorough knowledge of ID and other developmental disability related conditions, HCS, TxHmL, CLASS, DBMD and ICF/IID program rules, service array and billing guidelines, local authority functions and waiver service system. Awareness of federal and state laws relating to long term care and other Medicaid and non-Medicaid services and programs.

Knowledge of program planning, implementation and evaluation and continuous quality improvement.

Ability to communicate effectively, both orally and in writing.

Ability to multi-task, handle stress and meet deadlines.

Initial Screening Criteria:

Meets the criteria for designation as a QIDP.  Graduation from an accredited four-year college or university with a degree in human services or related field.

Minimum four years’ experience with intellectual/ development disabilities or related conditions.  

Minimum two years’ experience supervising or managing a department. 

Ability to use a personal computer and related Microsoft Office software applications.

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Active Duty, Military, Reservists, Guardsmen, and Veterans:

Military occupation(s) that relate to the initial selection criteria and registration or licensure requirements for this position may include, but not limited to those listed in this posting. All active-duty military, reservists, guardsmen, and veterans are encouraged to apply if qualified to fill this position. For more information please see the Texas State Auditor’s Job Descriptions, Military Crosswalk and Military Crosswalk Guide at Texas State Auditor's Office - Job Descriptions.

ADA Accommodations:

In compliance with the Americans with Disabilities Act (ADA), HHSC and DSHS agencies will provide reasonable accommodation during the hiring and selection process for qualified individuals with a disability. If you need assistance completing the on-line application, contact the HHS Employee Service Center at 1-888-894-4747. If you are contacted for an interview and need accommodation to participate in the interview process, please notify the person scheduling the interview.

Pre-Employment Checks and Work Eligibility:

Depending on the program area and position requirements, applicants selected for hire may be required to pass background and other due diligence checks.

HHSC uses E-Verify. You must bring your I-9 documentation with you on your first day of work. Download the I-9 Form

Telework Disclaimer:

This position may be eligible for telework.  Please note, all HHS positions are subject to state and agency telework policies in addition to the discretion of the direct supervisor and business needs.