Program Specialist VII

Texas Health & Human Services Commission Austin, TX
The Program Specialist VII reports to the Director for Strategy & Innovation, Program Enrollment & Support, Medicaid CHIP Services and performs senior level consultative and technical work, including planning, coordinating and implementing major agency program(s). This position serves in a lead position role as the liaison between PES and all Medicaid CHIP Services program areas and internal and external stakeholders (including managed care organizations). This position represents PES on cross-functional teams and workgroups and represents the Director of Strategy & Innovation at meetings. This positions assists in the development of communications to convey agency information to the public, governmental agencies, health care providers, advocacy associations, legislative audiences, and internal and external stakeholders (including managed care organizations). This position implements highly advanced short and long term planning work while leading new managed care strategies and innovations. This position conducts complex research and analysis of managed care member enrollment issues, including examination of rules, polices, laws, and regulations including legislative analysis that impact or potentially impact managed care programs. This position works under limited direction, with extensive latitude for the use of initiative and independent judgment. Essential Job Functions:

30% Ensures timely submission of required deliverables to HHSC or delegated partners to support managed care programs. Oversees the review of federal and state regulations that impact MCD contracts. Manages the development and implementation of policies and procedures for Medicaid CHIP Services Program Enrollment & Support. Coordinates the development of Medicaid/CHIP Services Managed Care initiatives with managed care organizations along with TMHP and other HHSC system developers as needed.25% Produces effective executive level written and oral communication. Represents the agency at internal and external business meetings, workgroups, and project implementation teams. Presents complex materials in understandable formats. Develops program and data analysis designed to promote continual quality and operational improvements.20% Develops and leads long and short term operational framework for processes that support the following program areas: Client Enrollment Resolution, Enrollment Broker Operations, 1915c Wavier Program Enrollment & Managed Care Program Support and Interest List Management. Works closely with staff from other MCD program areas and agencies that manage long range strategic planning and daily operations of Medicaid and CHIP programs. 15% Responds to HHSC legislative appropriations requests and legislative analysis to plan for adequate and appropriate support and funding for program services.10% Oversees the completion of required administrative and performance reports, studies and specialized projects and recommends appropriate changes. Consults with public and private agencies involved in program(s) to resolve problems, identify training needs, and discuss program effectiveness. Identifies the need for and implements new programs. Provides guidance to staff in the development and integration of new methods and procedures. Trains and leads the work of others. Performs related work as assigned. Knowledge Skills Abilities:

* Strong leadership skills with the ability to think both strategically and analytically.•Strong networking, collaboration, and influencing skills. •Experience leading and participation in cross-departmental and inter and intra-agency teams to effectively managed care organization project planning and compliance with all managed care programs (STAR, CHIP, STAR Health, STAR+PLUS, and STAR Kids). In-depth knowledge of Medicaid and STAR, CHIP, STAR Health, STAR+PLUS, and STAR Kids) operations; and working knowledge and experience in coordinating and overseeing managed care program operations and project implementation activities. •Skill in leading/facilitating large workgroups. •Knowledge of state and federal laws and regulations specific to Medicaid and CHIP programs, and contracting. •Knowledge and experience with the State of Texas' legislative process. •Skill in effective negotiation and application of risk management strategies. •Skill in working constructively and efficiently with managed care organization and HHSC agency staff to coordinate complex managed care enrollment issues. •Ability to routinely identify and effectively mitigate risks. •Ability to develop and implement strategic plans, goals, objectives and evaluation tools to monitor progress and ensure accountability. •Ability to communicate effectively and on different comprehension levels, build and maintain effective working relationships, negotiate with individuals and groups, develop professional networks and identify the internal and external dynamics that impact the work of the organization. Registration or Licensure Requirements:

N/AInitial Selection Criteria:

Graduation from an accredited four-year college (related experience may be substituted for college degree), plus 2 years of experience in Medicaid/CHIP programs with significant experience and knowledge of Medicaid/CHIP Managed Care Program operations, implementation, and innovation development in generally preferred. Experience and education may be substituted for one another. Evidence of a history of successfully exercising initiative and creativity, being a self-starter, and having strong analytical and communication capabilities. Skill in using personal computer application software such as Microsoft Word, Power Point, Excel, Access or similar programs. Additional Information:

Req 384471"Note: There are no direct military occupation(s) that relate to the initial selection criteria and registration or licensure requirements for this position. All active duty, reservists, guardsmen, and veterans are encouraged to apply. For more information see the Texas State Auditor's Military Crosswalk at" MOS Code:

No direct military equivalent.

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In compliance with the Americans with Disabilities Act (ADA), HHS 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.