Human Service Spec V

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. Our comprehensive benefits package includes 100% paid employee health insurance for full-time eligible employees, a defined benefit pension plan, generous time off benefits, numerous opportunities for career advancement and more. Explore more details on the Benefits of Working at HHS webpage.

The Human Services Specialist (HSS) V for the Comprehensive Rehabilitation Services Program (CRS) reports to the CRS Purchasing Manager. The HSS supports the team utilizing Person-Centered Planning, Wraparound and Trauma Informed Care to provide rehabilitation services supports to individuals with Traumatic Brain Injuries (TBI) and/or Traumatic Spinal Cord Injuries (TSCI). Collaborates with internal and external stakeholders to ensure continuity of care. Coordinates medical services and supports; including but not limited to, explaining program benefits and requirements, scheduling, collecting eligibility documents, obtaining quotes, identifying and utilizing comparable benefits, issuing services authorizations, managing caseload budget, collecting billing and claims information for payments. Participates in contract monitoring and quality assurance activities. Serves as a subject matter expert regarding complex medical issues, goods and services, medical terminology, assistive technology and procedure coding. The HSS works independently with latitude to use critical thinking and problem solving to establish and maintain effective business relationships with individuals we support, their families, providers, and colleagues to ensure individuals we support needs are met. May mentor peers or oversee the work of others. May require travel outside immediate office location to accomplish assignments.

Essential Job Functions:

1. Oversees and coordinates the provision of services for the individuals CRS supports which includes scheduling, obtaining quotes, identifying, and utilizing comparable benefits, issuing services authorizations, managing caseload budget, collecting billing and needed information related to service provision to make payment. (30%)

2. Assist the Social Worker with caseload management, utilizing critical thinking and problem solving to ensure people's needs are met. Fosters positive collaboration with internal and external providers and stakeholders with focus on solution-based outcomes. Collaborates with assigned Social Worker, the individuals we support, families, and providers as needed to obtain necessary documentation, arrange services and process claims. (25%)

3. Documents all tasks, case related activities, and communication with individuals we support, their families, and providers in the designated electronic case management system and the data reporting system. Completes administrative activities, reports, and maintains consumer case files to ensure case file is properly maintained and organized. (20%)

4. Provides education, information and technical assistance regarding the CRS Program and services to individuals we support, families, internal and external stakeholders. Serves as subject matter experts on medical and rehabilitation services, coordination of services and payment methodology. Supports other colleagues to manage workload priorities, assisting with complicated medical issues and promotes an effective and cohesive team. May mentor peers and oversee the work of others to provide technical assistance, training and consultation to support related assignments, work abilities, and professional growth. (10%)

5. Coordinates and participates in contract compliance and monitoring activities to ensure compliance regarding medical and physical rehabilitation services in accordance with the program’s policy and standards. Adhere to all program policies, standards and procedures. May also assist in development of policies, standards and procedures. (5%)

6. Complete applications for services, explain program benefits and requirements, schedule interviews, and collect eligibility documents. (5%)

7. Performs other duties as assigned to ensure continuity of case and maintain positive consumer outcomes. (5%)

Registrations, Licensure Requirements or Certifications: None

Knowledge Skills and Abilities.

List the knowledge, skills, and abilities critical to performance in this position:

Knowledge of:

• Rehabilitation and social services programs; traumatic brain injury and traumatic spinal cord injury; and assistive technology for individuals with disabilities.
• Experience in case or caseload management[P(1]
• Rehabilitation services and medical terminology.
• State of Texas purchasing policies and procedures.
• State of Texas contracts and monitoring techniques.
• Comparable benefits for medical services.

Skill in:

• Providing technical assistance to providers related to contracts and service delivery.
• Managing multiple and competing priorities.
• Understanding and applying policies and procedures.
• Working collaboratively and cooperatively with diverse groups including individuals seeking services, contractors, vendors, and internal and external stakeholders.
• Utilizing Microsoft Office programs including Word, Outlook, and Excel.
• Medical billing, coding and processing claims.

Ability to:

• Educate individuals and family members regarding community resources and available medical services.
• Communicate effectively orally and in writing.
• Read, interpret and implement policies and procedures.
• Plan, organize and achieve goals.
• Organize and maintain individual case files.
• Review, request funds and track caseload budgets.

Initial Criteria

• High School diploma or equivalent
• Experience with medical billing, coding or claims
• One year of experience providing customer service in a rehabilitation, medical or social service setting

Preferred Criteria:

• Associate degree or higher in medical or human services related field
• Experience in case or caseload management
• Experience working with individuals with traumatic brain injury, traumatic spinal cord injury, complex medical needs or other disabilities.
• Experience in administrative duties, documentation or records management

Review our Tips for Success when applying for jobs at DFPS, DSHS and HHSC.

Active Duty, Military, Reservists, Guardsmen, and Veterans:

Military occupation(s) that relate to the initial selection criteria and registration or licensure requirements for this position may include, but not limited to those listed in this posting. All active-duty military, reservists, guardsmen, and veterans are encouraged to apply if qualified to fill this position. For more information please see the Texas State Auditor’s Job Descriptions, Military Crosswalk and Military Crosswalk Guide at Texas State Auditor's Office - Job Descriptions.

ADA Accommodations:

In compliance with the Americans with Disabilities Act (ADA), HHSC and DSHS 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.

Pre-Employment Checks and Work Eligibility:

Depending on the program area and position requirements, applicants selected for hire may be required to pass background and other due diligence checks.

HHSC uses E-Verify. You must bring your I-9 documentation with you on your first day of work. Download the I-9 Form