Quality Managment Specialist

Join the Texas Health and Human Services Commission (HHSC) and be part of a team committed to creating a positive impact in the lives of fellow Texans. At HHSC, your contributions matter, and we support you at each stage of your life and work journey. Our comprehensive benefits package includes 100% paid employee health insurance for full-time eligible employees, a defined benefit pension plan, generous time off benefits, numerous opportunities for career advancement and more. Explore more details on the Benefits of Working at HHS webpage.

JOB DESCRIPTION:

Each Program Specialist V works under the general direction of the Quality Managment Director with considerable latitude for use of initiative and independent judgment. Specialist functions as part of a team of staff specifically designated to work on oversight and management of Medicaid 1915(c) program, called Youth Empowerment Services (YES). The YES program is designed to allow the provision of alternative community based services to avert hospitalizations.

Specialist perform advanced (senior-level) consultative services and technical assistance work that involves working with community based waiver providers. Duties may include but are not limited to: program education for potential providers, technical assistance for program providers, monitoring provider and authority contract and waiver compliance, clinical oversight, service delivery oversight, quality management activities, data analysis, and program evaluation.

Specialist will work closely with HHSC Quality Management and Decision Support Units, the Texas Health and Human Services (HHSC) and Centers for Medicare and Medicaid Services (CMS) to ensure compliance with the waiver and contract requirements, develop and implement program goals and objectives, and ensure project course corrections when needed. Works closely with the mental health providers contracted to provide waiver program services to resolve problems and discuss program effectiveness.

ESSENTIAL JOB FUNCTIONS (EJF):

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

1.Provides complex consultative services and technical assistance to plan, implement, and monitor waiver program services. Works closely with community based providers and local mental health authorities. (15%)

2.Develops policies and procedures related to implementation and monitoring of waiver program services. Ensures that local mental health authorities and other community based providers receive training on new policies and procedures, and that periodic monitoring takes place. (15%)

3.Conducts and coordinates desk and onsite reviews to determine compliance with waiver program requirements, laws, regulations, policies, and procedures. Analyzes reviews of waiver program services and develops action plans to improve effectiveness, if needed. Communicates those findings, orally and in writing, to a wide variety of audiences, including DSHS, HHSC, and CMS. (15%)

4.Ensures that there is continuous quality monitoring program in place to ensure that identified problems are acted upon and resolved promptly. Determines when course corrections are required when program or program provider is not achieving goals or objectives. (10%)

5.Collects, organizes, analyzes, and prepares material in response to requests for information from internal and external stakeholders. Synthesizes complex information for presentation to a wide variety of groups, orally and in writing. These groups consist of DSHS leadership, HHSC leadership, CMS and local stakeholders. (15%)

6.Determines trends and resolves operational problems, within DSHS and within LMHAs and/or waiver provider organizations. These consist of service delivery issues, data collection/submission issues, data entry issues, data analysis issues, invoicing processing issues (by providers), invoice processing issues (by DSHS) . (10%)

7.Participates in waiver renewal and amendment, and maintenance processes. . (15%)

8.Performs related work as assigned (5%)

KNOWLEDGE, SKILLS AND ABILITIES REQUIRED:

•Knowledge of program planning and implementation.

•Knowledge of public mental health systems.

•Knowledge of mental health issues and treatment modalities.

•Knowledge of Medicaid services

•Ability to function effectively in a fast paced environment, to oversee/manage multiple complex projects simultaneously, and to meet deadlines.

•Ability to exercise initiative and independent judgment

•Ability to analyze data for completeness and accuracy and to utilize data to identify issues, trends, and other programmatic needs.

•Ability to interact with multiple, diverse stakeholder groups.

•Ability to effectively communicate orally and in writing.

REGISTRATIONS, LICENSURE REQUIREMENTS or CERTIFICATIONS:

N/A

INITIAL SELECTION CRITERIA:

Graduation from an accredited four-year college or university with major coursework in health services, business administration, human services, social work or a related field is required. Advanced degree from a U.S. accredited college or university with specialization in public administration, health services, business administration, human services, or related areas, or equivalent post Master's degree preferred.Licensed Practitioner of the Healing Arts (LPHA) in accordance with Texas Administrative Code §412.303 MENTAL HEALTH COMMUNITY SERVICES STANDARDS, Subchapter G preferred, not 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