[Hiring] Operations and Readiness Review Specialist @Texas Health & Human Services Commission

Role Description

The Texas Health and Human Services Commission (HHSC) Medicaid CHIP Services (MCS) department seeks a highly qualified candidate to fill the position of Operational and Readiness Review Specialist. 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 ensuring Managed Care Organization’s (MCOs) meet contract, state, and federal regulations through Operational and Readiness reviews. This position requires the necessity to travel monthly for operational reviews and as well as at a moment's notice based on significant MCO non-compliance.

Position will perform highly complex consultative services and technical assistance work. Work involves leading operational and readiness initiatives such as readiness reviews, operational reviews, and targeted reviews. Work involves planning, developing, and implementing major agency program(s) and providing consultative services and technical assistance to program staff, governmental agencies, community organizations, or the general public.

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
• Integrity to do things right even when what is right is not easy

The Operational and Readiness Review Specialist reports to the Manager of the Operational and Readiness Review Team in the Managed Care Contracts and Oversight (MCCO) MCS Division. Work also includes research and developing tools for reviews. Position will work in partnership with HHS program staff and contracted MCOs. Work includes evaluating MCO adherence to contracts, policies, programs, other government assistance and programs, and private sector resources. Position will contribute to the development of the monitoring teams within MCCO.

Position will apprise manager of work-related incidents or situations that could be problematic to staff, the department, or the agency. Position will communicate with manager on a timely basis with regard to problematic situations and apply proper judgment to assure action is appropriate. Position works under limited supervision and with considerable latitude for the use of initiative and independent judgment.

Qualifications

• Certified Texas Contract Manager Certification (CTCM), or must obtain within 12 months upon hire. Must maintain CTCM certification.

Requirements

• A minimum of 120 semester hours from an accredited college with major coursework in a field related to health and human services.
• Graduation from an accredited four-year college or university with major course work in a field relevant to healthcare administration, health information technology, or management is generally preferred.
• Minimum of two years of experience with Medicaid and CHIP managed care programs, policies, procedures, contracts, and service delivery models.
• Minimum of two years of experience in contract management and contract principles.
• Minimum of two years of experience in research, analysis, and creating technical reports in an understandable format.
• Minimum of two years of experience using a PC and Microsoft Office Suite, including: Word, Excel, PowerPoint, Outlook.

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