HCS/TxHmL/ICF Program Advisor

Job Description:

The Texas Health and Human Services Commission (HHSC) Medicaid CHIP Services (MCS) division 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 highly complex consultative and technical assistance for the Intellectual and Developmental Disabilities Program Eligibility and Support (IDD PES) unit.

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.

The Program Specialist IV reports to the Unit Manager within IDD PES and works as a team member to support unit functions.

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), the Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Condition (ICF/IID), and 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 the review and processing of enrollments, transfers, terminations, and suspensions for the HCS and TxHmL programs. Work also involves monitoring enrollment activities, such as Individual Plans of Care (IPC) and Level of Care/Level of Need (LOC/LON) determinations. Routinely reviews and analyzes HCS and TxHmL program activity data to assess the need for additional oversight. Work also involves monitoring provider and LIDDA inquiries and ensures timely resolutions. Evaluates enrollment IPC and eligibility activities and trends to resolve technical problems, identify opportunities for improvement, and to make recommendations for improvements in review processes. Conducts analysis of data and reports as assigned, and collects, organizes, analyzes and prepares materials in response to requests for program information, or special project reports. Develops and revises review tools (e.g., review protocols, evaluation forms, etc.) in accordance with program objectives and goals. Will serve as the lead to prioritize the work of colleagues by assigning provider deliverables to designated unit staff in absence of the HCS/TxHmL/ICF Unit Manager. Conducts training and provides guidance to staff in the development or integration of new or revised operational procedures. Coordinates and collaborates with program staff through participation in unit and cross-agency workgroups related to unit functions and planning to analyze, develop, and implement program initiatives. Works under limited supervision with moderate latitude for the use of initiative and independent judgment.
 

Essential Job Functions:

Works collaboratively across MCS to identify innovative and effective solutions. Attends work on a regular and predictable schedule in accordance with agency leave policy and performs other duties as assigned.

(30%) Provides highly complex consultative and technical assistance, including research, assessment and planning directly to management, HHSC program staff, HHSC contract management staff, LIDDA staff, the program provider base, advocacy groups, stakeholders, program participants and their families.

(25%) Conducts analysis of data and reports as assigned, and collects, organizes, analyzes, and prepares materials in response to requests for program information, or special project reports.

(15%) Coordinates and collaborates with program staff through participation in unit and cross-agency workgroups related to unit functions and planning to analyze, develop, and implement program initiatives.  

(10%) Develops and revises review tools (e.g., review protocols, evaluation forms, etc.) in accordance with program objectives and goals. 

(10%) Conducts training and provides guidance to staff in the development or integration of new or revised operational procedures. 

(5%) Serves as agency representative in fair hearings.

(5%) Will serve as the lead to prioritize the work of colleagues by assigning provider deliverables to designated unit staff during the absence of the HCS/TxHmL/ICF Unit Manager.  

Registrations, Licensure Requirements or Certifications:

Qualification as a Qualified Intellectual Disability Professional (QIDP) as defined in 42 Code of  Federal Regulations 483.430(a) preferred.  

Knowledge Skills Abilities:

• Knowledge of intellectual disabilities and other developmental disabilities (such as related conditions).
• Knowledge of HCS, TxHmL, and/or ICF/ID program rules, service array and billing guidelines, LIDDA functions and/or waiver service systems.
• Awareness of federal and state laws relating to long term care and other Medicaid and non-Medicaid services and programs.
• Knowledge of program planning, implementation and evaluation and continuous quality improvement.
• Skilled in the development and maintenance of interpersonal relationships and public speaking.
• Ability to communicate effectively, both orally and in writing.
• Ability to gather, assemble, correlate, and analyze information
• Ability to train, lead, and/or prioritize the work of others.
• Ability to operate computers and experience using Microsoft Office products.
• Ability to work collaboratively across MCS to accomplish objectives.
• A keen attention to detail and the ability to implement creative solutions to problems.
• Able to balance team and individual responsibilities.
   

Initial Screening Criteria:

• Work experience with HCS, TxHmL, and/or ICF/ID program rules, service array and billing guidelines, LIDDA functions, and/or Texas waiver service system. 
• Knowledge of and experience working with the Long Term Care Online Portal (LTCOP) preferred.
• Experience in conducting staff trainings preferred.