Manager of Quality Review for the Provider Finance Department

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Brief Job Description

The Provider Finance Department’s Manager of Quality Review (Manager V; Salary Group B26) reports to the PFD Director of Quality Review and Training. The PFD Manager of Quality Review supervises the Quality Review Team, which is comprised of data analysts, financial examiners and technical writers. The position performs advanced (senior-level) managerial work providing direction and guidance in planning and executing quality assurance and quality control work. Work involves overseeing various activities to ensure consistency with state and federal laws and regulations, performance standards, and agency policies and procedures; overseeing the review of various data analyses, financial calculations, and written reports, and evaluating opportunities to improve departmental economy, efficiency, and effectiveness; developing policies, procedures, and guidelines; establishing priorities, standards, and measurement tools for determining progress in meeting goals; and overseeing the review and evaluation of fiscal and operational records to determine condition, level of internal control, and compliance with statutory requirements. Supervises the work of others. Works under minimal supervision, with extensive latitude for the use of initiative and independent judgment.

Essential Job Functions

Management: Manages day-to-day activities of staff within a large and/or highly complex business function(s), division(s), or department(s). Oversees the allocation of resources to achieve timely outcomes and measurable goals; and monitors and evaluates the effectiveness and efficiency of staffing levels. (30%)

Change Management: Develops and implements techniques for evaluating business function, division, or department activities. Reviews and evaluates the impact of proposed federal and state laws on program objectives. Identifies areas of needed change and makes recommendations to improve operations. May manage multiple business functions and provide oversight to associated staff. (25%)

Reporting: Oversees special investigations, research studies, special projects, internal audits, and the implementation of special initiatives. Prepares management and productivity reports; and reviews and approves documents and reports developed by employees to ensure professional quality and appearance, appropriate content, consistency, and responsiveness. (25%)

Monitoring: Establishes goals and objectives; develops and approves schedules, priorities, and standards for achieving goals; and manages evaluation activities. Monitors compliance with policies and procedures; and provides input or approves new policies and procedures. (15%)

Performs other duties as assigned (5%)

Knowledge, Skills, and Abilities (KSAs)

·  Knowledge gathering and analysis of requested changes to determine the needs of the stakeholder;  

·  Knowledge of approaches used to deliver projects, products and services to large client organizations;  

·  Knowledge of state agency programs and procedures and of the methods and equipment;  

·  Knowledge of quality assurance and quality control methodologies; 

·  Skill in establishing and maintaining effective working relationships;

·  Excellent skills in effective verbal and written communication, including the ability to explain highly technical information to non-technical audiences and to translate system requests from non-technical staff to technical experts;  

·  Skill in analyzing processes and procedures and explain abstracts concepts in concrete terms;

·  Skill in office productivity software including Microsoft Office Suite to include MS Project, Access and Visio.  

·  Skill in creating work plans, develop work estimates and monitor progress; Skill in conducting research using large relational databases;  

·  Ability to clearly communicate with all team members and stakeholders;  

·  Ability to develop effective presentations for management, internal and external partners, technical teams and end user customers;  

·  Ability to work in a team setting;  

·  Ability to manage multiple tasks, projects and priorities;  

·  Ability to train and mentor support staff;  

·  Ability to analyze processes and procedures and develop and revise procedures;  

·  Ability to plan, assign, and/or supervise the work of others;  

·  Ability to analyze problems and develop solutions.

· Ability to analyze processes and procedures, to write and revise standards and procedures, and to communicate effectively.

Licensure Requirements or Certifications

Certification in Lean Six Sigma or similar quality assurance programs is preferred, but not required.

Initial Selection Criteria

Graduation from a 4-year college or university. At least 3 years of experience in quality assurance or quality control process development or review work. At least 1 years of experience as a supervisor or 3 years of experience as a team lead. Knowledge of HHS processes, procedures, and policies preferred.

Additional Information

Position is eligible to telework up to 3 days per week at this time, but telework schedules may be updated in accordance with HHSC telework policies in the future. 

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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.