[Hiring] Program Specialist III @Texas Health & Human Services Commission

Role Description

Medicaid and CHIP Services (MCS) at the Texas Health and Human Services Commission (HHSC) seeks a highly qualified candidate to fill the position of Program Specialist III. 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 providing moderately complex consultative and technical assistance for the Intellectual and Developmental Disabilities Program Eligibility and Support (IDD PES) unit. The Program Specialist III reports to the Unit Manager within IDD PES.

The IDD PES team is responsible for ensuring eligible Texans are enrolled in programs serving individuals with intellectual and/or developmental disabilities. These programs include:

• Home and Community-based Services (HCS)
• Texas Home Living (TxHmL)
• Community Living Assistance and Support Services (CLASS)
• Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Condition (ICF/IID)
• Community First Choice Non-Waiver (CFC NW)

IDD PES staff authorize and verify programmatic eligibility for the listed programs. In addition, IDD PES staff process enrollments, transfers, suspensions, and terminations for HCS, TxHmL, and CLASS and coordinate and attend Fair Hearings.

Work involves:

• Review and processing of enrollments, transfers, terminations, and suspensions for the HCS and TxHmL programs.
• Monitoring enrollment activities, such as Individual Plans of Care (IPC) and Level of Care/Level of Need (LOC/LON) determinations.
• Coordinating with local IDD authorities (LIDDAs) to monitor individuals whose services have been suspended.
• Serving as a liaison with Medicaid for the Elderly and Persons with Disabilities (MEPD) to verify financial eligibility (Medicaid) for the program.
• Monitoring provider and LIDDA inquiries and ensuring timely resolutions.
• Conducting analysis of data and reports as assigned, and collecting, organizing, analyzing and preparing materials in response to requests for program information or fair hearings.
• Assisting in creating presentation material, organizing documents and may present program rules, policy and procedure information to internal and/or external stakeholders.

Works under general supervision with moderate latitude for the use of initiative and independent judgment.

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.

Qualifications

• Knowledge of Medicaid waiver programs (such as HCS, TxHmL, or ICF/IID).
• Knowledge of federal and state laws relating to long term care and/or other Medicaid and non-Medicaid services and programs.
• Knowledge of program planning, evaluation, and implementation.
• Skilled in organization and prioritization.
• Ability to communicate effectively, both orally and in writing.
• Ability to understand and follow policies and procedures.
• Ability to maintain accurate files, records, and databases.
• Ability to gather, assemble, correlate, and analyze information.
• Ability to operate computers and experience using Microsoft Office products.

Requirements

• Work experience within a Medicaid program (such as HCS, TxHmL, or ICF/IID).
• Experience working with the Long Term Care Online Portal (LTCOP) and/or Texas Integrated Eligibility Redesign (TIERS) systems preferred.
• Experience using Microsoft Office products.

Benefits

• 100% paid employee health insurance for full-time eligible employees.
• A defined benefit pension plan.
• Generous time off benefits.
• Numerous opportunities for career advancement.

Company Description

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.