Therapy Policy Analyst (Registered Therapist V)

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.

Brief Job Description

The Texas Health and Human Services Commission (HHSC) Medicaid CHIP Services (MCS) department seeks a highly qualified candidate to fill the position of Therapy Policy Analyst. 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 performing complex and very technical analysis and consultation for the Medicaid/CHIP Policy Development Division.

This position reports directly to the Medical Benefits Policy Manager in the Office of Program and Policy, Medicaid and CHIP Services Department. The Therapy Policy Analyst (Therapist V) leads the development, planning, and implementation of medical benefits related to therapeutic practices within Texas Medicaid, including participating in and at times leading committees, work groups, or activities as requested. The therapy analyst in this position must be proactive in seeking input from other staff in the Medicaid/CHIP Division and demonstrate the ability to work as an effective team member with other divisions within HHSC and other HHS agencies. The Therapy Policy Analyst researches and gathers relevant information from a variety of resources, including current research and literature related to recommended evidence-based therapeutic practice; synthesizes findings for a clinical and lay audience and applies findings to the therapeutic medical benefits in the Medicaid program; provides expert consultation to staff, other agencies, and external persons including legislators and managed care organizations on current medical therapeutic policies; stays abreast of current national therapeutic standards and requirements affecting clinical and therapeutic aspects of the Texas Medicaid medical benefits.

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.

Essential Job Functions

(30%) Develops policies and benefits - Reviews current benefits and develops new benefits for Medicaid medical policy. Identifies eligibility standards and authorization requirements for policies. Collaborates, as needed, with HHSC staff in other programs and other State agencies in program benefit policy development, planning, and implementation. Develops, reviews, and provides comments on Medicaid materials intended for use by vendors, providers, managed care organizations, and other partners.

(25%) Clinical Research - Researches, analyzes, and synthesizes peer reviewed literature and evidence-based practices and applies it to program medical benefit policy. Provides complex technical medical information verbally or in writing to nonclinical audiences. Consults with stakeholders to address Medicaid program benefit policy issues.

(25%) Special Projects and Workgroups - Leads or participates in workgroups, special projects, and public meetings regarding research, analysis, and evaluation of policy issues or initiatives. Positively represents department, agency, and State in conferences and meetings and as an ongoing representative on various committees and teams. Prepares project updates, summaries, reports, or other documents and keeps management informed on pertinent issues. Functions as a resource to other State staff providing guidance, advice, or direction. Responds to internal and external communications and requests for information in a timely manner. Identifies the need to, and communicates and consults with external stakeholders, as necessary.

(15%) Quality Assurance - Participates in quality assurance activities through: Development and review of program behavioral health benefits, including reviewing documentation, document tracking research, policy development, and reviewing discussions and draft program benefit policy changes. Researching provider or manufacturer questions or concerns. Assists in the review and referral of complaints concerning medical and other providers and services.

(5%) Regulation review - Reviews, analyzes, and comments on regulations affecting program benefit policy. Other duties, as assigned, include but are not limited to actively participating in or serving in a supporting role to meet the agency's obligations.  

Registrations, Licensure Requirements or Certifications:

Licensed as an occupational therapist (OT), physical therapist (PT), or speech language pathologist in the state of Texas and education that meets the minimum standards for licensure.  

Knowledge, Skills, and Abilities

Knowledge of:

• Health and human service programs.
• Principles of clinical therapeutic evaluation and treatment and their application to the treatment of individuals in the Medicaid population.
• Physical, occupational, and speech therapy practice guidelines, evaluations, or knowledge base.

Skill in:

• Researching and conducting comprehensive literature reviews using PubMed/Medline, Hayes, or other electronic databases.
• Balancing team and individual responsibilities.  
• Written, verbal, and interpersonal communication and presentation skills.

Ability to:

• Work well with staff, foster the team process, and assume leadership role as needed.
• Work independently and function effectively as a member of a team under tight deadlines with a high volume workload.
• Facilitate meetings.
• Implement creative solutions to problems with a keen attention to detail.

Initial Screening Criteria

Required: 

• Bachelor's Degree

Preferred: 

• Master's Degree 
• Experience applying evidenced-based research to policy and performing comprehensive literature reviews.    

Additional Information 

Benefits of joining the MCS Office of Policy include:

• Leadership commitment to invest in and foster your professional growth or knowledge of the Texas Medicaid program and your career advancement.
• Having a profound impact to the lives of thousands of Medicaid clients that depend on Medicaid Services throughout Texas.
• Being on the ground level of medical benefits implementation, including the opportunity to work closely with stakeholders such as federal partners, providers, advocates, managed care organizations, and other healthcare contractors.
  
• Engagement with the Texas legislative process to analyze and inform legislators of potential impact of proposed bills.
  
• Being part of a team at the forefront of interpreting, implementing, and developing policy that has statewide impact.
  
• The opportunity to learn and engage with multiple domains of the healthcare delivery system, including managed care, fee-for-service, federal/state Medicaid partnerships and other activities related to the administration of the Medicaid program.
  

Note: Factors including but not limited to HR Policies, budgetary limitations, qualifications, experience, and tenure will determine the final salary offer.  

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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.