Program Specialist III (Information Specialist)

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Brief Job Description:

The HHSC Medicaid and CHIP Services (MCS) division seeks a highly qualified candidate to fill the position of Program Specialist III in the Provider Resolution & Administrative Appeals (PRAA) unit. The PRAA unit provides oversight of the Texas Medicaid administrative contractors in the areas of claims management, provider enrollment, and administrative appeals. PRAA also handles customer service inquiries, provider administrative appeals for claim payments, updates to trainings and provider handbooks and manuals, liaison for approving provider notifications related to claims, provider enrollment and administrative appeals.

Under the supervision of the PRAA Manager, the Program Specialist III performs complex (journey level) consultative services and technical assistance work as the unit’s communications and information management specialist.

The information specialist monitors public mailboxes and processes all incoming inquiries and correspondence from various stakeholder and program areas. The specialist assigns inquiries to appropriate staff and ensures assignments are completed within designated timeframes. All assignments are routed, entered, and tracked in the PRAA Customer Relations Management (CRM) system. The specialist follows all records management policies and procedures; and ensures confidentiality of any client and sensitive information received. May perform other related duties as assigned for the benefit of the program.

The ideal candidate thrives in an environment that emphasizes teamwork to achieve goals, excellence through high professional standards and personal accountability, and curiosity to continuously grow and learn.

Essential Job Functions:

Manages and coordinates communication processes for all program-related inquiries. Monitors all PRAA shared email inboxes for program information requests. Responsible for reviewing, analyzing, responding, tracking, and routing inquiries within established service level timelines. Coordinates with senior staff and subject matter experts on complex inquiries. Collaborates with program staff to determine appropriate responses; responds to inquiries via telephone or in writing. (30%)

Performs specialized research on issues and/or questions submitted by stakeholders regarding PRAA program processes and procedures. Conducts analysis and collaborates with program staff in determining trends and recommends procedural changes. (20%)

Prepares meeting documentation including meeting minutes, assignments, assignment owners and due dates. Documents meeting minutes and action items suitable for public record and for review by internal and external stakeholders. Writing must be succinct, professional, and clearly identify action item owners and due dates. Tracks action items and due dates and uploads meeting documents to file repository and stores according to agency record retention schedules. (10%)
 

Completes tracking of all incoming communications to the PRAA mailboxes; updates PRAA tracking database; and prepares reports in response for program information. (15%)

Reviews and completes provider visit maintenance requests in accordance with PRAA policies. (20%)
 

Completes additional tasks, projects or other duties as assigned. (5%)

Knowledge Skills Abilities:

• Knowledge of Medicaid provider enrollment process preferred.
• Knowledge of modern office practices and procedures.

• Skill in verbal communication.
• Skill in using Microsoft Office software programs.
• Skill in written communication acceptable for publication.
• Skill in the use of computer and related equipment.
• Skill in tracking incoming and outgoing correspondence.
• Skill in drafting, editing and formatting documents, agendas, and other meeting materials.
• Skill in organizing and facilitating meetings including planning, scheduling, preparing, and conducting support activities.

• Ability to organize, prioritize assignments, and coordinate administrative assignments, and adhere to strict deadlines.
• Ability to effectively communicate verbally and in writing to organize and present information to others.
• Ability to produce high-quality work.
• Ability to organize and distribute correspondence based on the topic.
• Ability to organize and facilitate virtual meetings.
   

Registration or Licensure Requirements:
None  

Initial Selection Criteria:
 

• Graduation from high school or equivalent required.
• Advanced Microsoft Office experience.
• Advanced experience drafting, editing, and tracking correspondence.
• Experience responding to customer inquiries.

Preferred:

• Graduation from an accredited four-year college or university with major coursework in business is generally preferred. Experience and education may be substituted for one another.
• Preferred experience working on health and human services program-related assignments.
• Preferred experience performing a variety of detailed research and analysis.
• Preferred experience in coordinating and collaborating on assignments with other departments.

Additional Information:
 

1. Your application must be complete and contain all the requested information. Job histories must demonstrate how you meet the initial selection criteria at a minimum.
2. Interviews will include an In-basket writing exercise.
3. Any employment offer is contingent upon available budgeted funds. The offered salary will be determined in accordance with budgetary limits and the requirements of HHSC Human Resources Manual.
4. This position is eligible for partial telework in accordance with applicable HHSC policies. Some on-site work will be required.

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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