Program Specialist II
Location: Lubbock, Texas
Description: Texas Department of Family and Protective Services is at present looking to employ Program Specialist II right now, this vacancy will be ordered in Texas. More details about this vacancy opportunity please read the description below. Serves as Provider Relations representative to Medicaid providers in the Texas health Steps Program (THSteps). Serves as liaison for provider relations activities for R! egion 1 that include, but are not limited to: recruiting new and existing Medicaid providers to the THSteps program, facilitating provider enrollment activities, billing resolutions, policy clarifications and technical assistance. Serves as a regional contact on policy issues. Communicates with and coordinates provider activities with the regional Texas Medicaid and Healthcare Partnership (TMHP) representative on an ongoing basis. Makes contacts with community based organization in an effort to increase the provider base and community awareness of both programs. Holds responsibility for conducting and developing professional presentation materials, using automated presentation software and equipment. Coordinates or participates in regional provider workshops. Duties are performed under the general direction of the Regional Manager for Specialized Health & Social Services and THSteps Team Leader with considerable latitude for the use of initiative and independent judgment. E! mployee actively participates and/or serves in a supporting ro! le to meet the agency’s obligations for disaster response and/or recovery or Continuity of Operations (COOP) activation.
Essential Job Functions:
Attends work on a regular and predictable schedule in accordance with agency leave policy and performs other duties as assigned.
(60%) Consultation/Education/Technical Assistance: Serves as Texas Health Steps provider relation’s liaison and consultant to medical and dental providers, provider groups and managed care organizations on program policies and procedures. Provides both phone consultation and on-site technical visits to providers to answer questions, resolve billing issues and offer problem solving assistance. Prepare and distribute reports as needed. Follows the THSteps protocol in handling all program complaints. Holds responsibility for integrity of regional provider data in the THSteps Provider Look-up software. Oversees phone surveys to keep participating THSteps provider informatio! n accurate. Collaborates with program stakeholders to identify THSteps provider training needs for program specific training and individualized training sessions. Holds responsibility for conducting and developing professional presentation materials, using automated presentation software and equipment. Develops educational packets, training presentations (Power Point), announcements, marketing materials, and survey tools. Uses personal computer to complete duties. Computer programs used are Word, Excel, Microsoft Publisher, and E-mail.
(20%) Provider recruitment and enrollment activities: Identifies areas where THSteps provider recruitment is needed giving particular attention to low participation rates and under-served areas. Analyzes and evaluates THSteps provider participation and client utilization related to program standards, needs and goals. Prepare and distribute reports as needed. Performs activities to identify and contact non-participating provide! rs with the goal of increasing participation in the THSteps program. Co! mmunicates and collaborates with provider relations staff with Texas Medicaid and Healthcare Partnerships, TMHP staff, applicable regional committees, provider groups and organizations to develop, evaluate and improve recruitment strategies and enrollment activities. Recruits new and existing Medicaid providers to the THSteps program and tracks enrollment applications.
(15%) Program Planning and Community Relations: Participates in program meetings and training. Attends targeted community meetings related to services for children. Assists with identification of health service needs for children and options for meeting those needs in the most cost-effective manner. Facilitates interagency coordination and community support for program objectives through special initiatives and participates in HHS agencies committees, coalitions, in-service staff training and special task forces to enhance client accessibility and increase utilization of THSteps services. Moni! tors client access issues and is knowledgeable of situations that may prevent recipients from obtaining checkups in a timely manner. Assists with the regional corrective action plans for areas of low client participation. Suggests appropriate modifications to regional plans, policies and procedures when necessary. Coordinates program services with the regional Managed Care Coordinator, Medicaid Managed Care Organizations, TMHP other DSHS programs and community groups, as appropriate. Presents program presentations to professional groups and community-based organizations. Assists with education activities to inform clients, school districts, local government officials, and community organizations to encourage and increase utilization of THSteps services. Coordinates utilization reviews with the oral health program.
(Marginal duties 5%) Completes special assignments and other duties as assigned. Required to respond to public health emergencies such as, but not limite! d to disease outbreaks, environmental exposures and weather conditions.! Performs other duties as assigned. Other duties as assigned include but are not limited to actively participating and/or serving in a supporting role to meet the agency’s obligations for disaster response and/or recovery or Continuity of Operations (COOP) activation. Such participation may require an alternate shift pattern assignment and/or location.
Knowledge Skills Abilities:
Knowledge of Medicaid programs, state and federal laws, and the recipient eligibility process;
Knowledge of public/private health care programs, policies and procedures
Knowledge of clinical and medical terminology;
Knowledge of health care specialties;
Knowledge of client barriers to health care services;
Knowledge of community resources and inter-relationships;
Knowledge of public health, Medicaid Managed Care, and the health care delivery system;
Knowledge of Texas Health Steps/EPSDT Program;
Skill in public speaking, effective verbal and wri! tten communication, and professional adult training methods;
Skill in interpreting, researching, evaluating, and applying policies, procedures, and regulations;
Skill in analyzing and devising solutions for problems identified;
Skill in organizing workload, setting priorities, and meeting deadlines;
Skill in developing and maintaining productive and effective working relationships;
Skill in using a PC;
Skill in Word, Excel, Microsoft Publisher, PowerPoint, and E-mail;
Skill in THSteps Provider Look-up software;
Skill in using automated presentation software and equipment;
Ability to develop and maintain a positive working relationship with peers;
Ability to work in teams and take directions from others;
Ability to work independently with minimum supervision;
Ability to work with community groups and coalitions;
Ability to analyze and evaluate conditions, document findings, and recommend solutions;
Ability to express id! eas clearly and concisely;
Ability to collect, compile, analyze, an! d evaluate data/statistics;
Ability to resolve billing issues;
Ability to write concise reports, announcements, and informational communication updates for distribution to large populations.
Ability to work in a fast-paced environment and adapt quickly to an ever-changing health care environment;
Ability to recruit providers for professional services
Registration or Licensure Requirements:
None required. Bachelor’s degree from an accredited college or university preferred.
Initial Selection Criteria:
Bachelor’s degree from an accredited college or university.
Experience working with Texas Medicaid and DSHS Medicaid covered services
Experience working with health care specialties
Experience in facilitation
Experience conducting workshops and conferences
Experience working in a team setting
Experience dealing with the public
Additional Information:
Headquarters will be! in the Lubbock office. Only applicants who are interviewed will receive written notification of selection results. Applicants must list Employer Posting Number on State of Texas application to be considered for this posting. If you need assistance completing the on-line application, contact the HHS Employees Service Center at 1-888-894-4747. May be required to work hours other than 8-5, M-F. Must comply with Department of State Health Services immunization policies. Employee must provide transportation. If employee operates a personal or state motor vehicle in performance of their official duties, the employee must possess a current valid Texas driver's license for the appropriate vehicle. Employees/applicants are responsible for providing a copy of their driver’s license prior to beginning employment. Only applicants who are interviewed will receive written notification of selection results.
req 245125
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If you were eligible to this vacancy, please em! ail us your resume, with salary requirements and a resume to Texas Depa! rtment of Family and Protective Services.
Interested on this vacancy, just click on the Apply button, you will be redirected to the official website
This vacancy starts available on: Fri, 01 Nov 2013 18:26:45 GMT
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