What are the responsibilities and job description for the Program Specialist IV position at Texas Health and Human Services?
Date: Jan 16, 2025
Location:
AUSTIN, TX
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.
Functional Title: Program Specialist IV
Job Title: Program Specialist IV
Agency: Health & Human Services Comm
Department: UR Wav & Comm Srvs Ran Mmt St
Posting Number: 2496
Closing Date: 01/30/2025
Posting Audience: Internal and External
Occupational Category: Community and Social Services
Salary Group: TEXAS-B-20
Salary Range: $4,263.16 - $6,779.25
Shift: Day
Additional Shift: Days (First)
Telework: Full-Time
Travel: Up to 5%
Regular/Temporary: Regular
Full Time/Part Time: Full time
FLSA Exempt/Non-Exempt: Nonexempt
Facility Location:
Job Location City: AUSTIN
Job Location Address: 701 W 51ST ST
Other Locations: Abilene; Alamo; Alice; Alpine; Alvin; Amarillo; Anahuac; Andrews; Angleton; Anson; Aransas Pass; Archer City; Arlington; Athens; Atlanta; Austin; Bacliff; Ballinger; Bandera; Bastrop; Bay City; Baytown; Beaumont; Bedford; Beeville; Bellville; Big Spring; Boerne; Bonham; Borger; Bowie; Brady; Breckenridge; Brenham; Brownfield; Brownsville; Brownwood; Bryan; Burnet; Caldwell; Cameron; Canton; Canutillo; Carlsbad; Carrizo Springs; Carrollton; Carthage; Center; Centerville; Childress; Clarksville; Cleburne; Cleveland; Coldspring; Columbus; Conroe; Copperas Cove; Corpus Christi; Corsicana; Crockett; Crosby; Crystal City; Cuero; Cypress; Daingerfield; Dallas; Decatur; Del Rio; Denton; Dickinson; Dumas; Duncanville; Eagle Pass; Eastland; Edinburg; El Paso; Elgin; Elsa; Ennis; Fabens; Falfurrias; Floresville; Fort Stockton; Fort Worth; Fredericksburg; Gainesville; Galveston; Garland; Gatesville; Georgetown; Giddings; Gilmer; Goliad; Gonzales; Graham; Granbury; Grand Prairie; Grapevine; Greenville; Hallettsville; Hamilton; Harlingen; Haskell; Hearne; Hemphill; Hempstead; Henderson; Hereford; Hillsboro; Hondo; Houston; Humble; Huntsville; Hurst; Irving; Jacksonville; Jasper; Johnson City; Jourdanton; Karnes City; Katy; Kaufman; Kerrville; Killeen; Kingsville; Kingwood; Kirbyville; La Grange; Lake Jackson; Lake Worth; Lamesa; Lampasas; Lancaster; Laredo; Levelland; Lewisville; Liberty; Linden; Littlefield; Livingston; Llano; Lockhart; Longview; Lubbock; Lufkin; Lumberton; Madisonville; Marble Falls; Marfa; Marlin; Marshall; Mcallen; Mckinney; Mercedes; Meridian; Mesquite; Mexia; Midland; Mineola; Mineral Wells; Mission; Monahans; Mount Pleasant; Mount Vernon; Nacogdoches; Navasota; New Boston; New Braunfels; Odessa; Orange; Palestine; Pampa; Paris; Pasadena; Pearland; Pearsall; Pecos; Perryton; Pharr; Pittsburg; Plainview; Plano; Pollok; Port Arthur; Port Lavaca; Presidio; Quitman; Raymondville; Refugio; Richardson; Richmond; Rio Grande City; Robstown; Rockwall; Rosenberg; Round Rock; Rowlett; Rusk; San Angelo; San Antonio; San Benito; San Juan; San Marcos; San Saba; Schertz; Seguin; Seminole; Seymour; Sherman; Silsbee; Sinton; Snyder; Socorro; Sonora; South Houston; Stephenville; Sugar Land; Sulphur Springs; Sweetwater; Taylor; Temple; Terrell; Texarkana; Texas City; The Woodlands; Tomball; Trinity; Tyler; Uvalde; Van Horn; Vernon; Victoria; Waco; Washington; Watauga; Waxahachie; Weatherford; Webster; Weslaco; Wharton; Wichita Falls; Woodville; Zapata
MOS Codes
16GX,60C0,611X,612X,63G0,641X,712X,86M0,86P0,88A0,88B0,8U000,OS,OSS,PERS,YN,YNS
Program Specialist IV The Texas Health and Human Services Commission (HHSC) Medicaid CHIP Services (MCS) department seeks a highly qualified candidate to fill the position of Program Specialist IV. 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 oversight and monitoring of provider requirements with Individual Plans of Care (IPC) and Level of Care/Level of Need (LOC/LON) determinations.
The Program Specialist IV position completes highly complex consultative and technical assistance, including research, assessment and planning directly to management, HHSC program staff, HHSC contract management staff, local authority (LIDDA) staff, the Home and Community-based Services (HCS), Texas Home Living (TxHmL), Community Living Assistance and Support Services (CLASS), Deaf Blind with Multiple Disability (DBMD) and Intermediate Care Facility (ICF/ID) provider base, advocacy groups, stakeholders, program participants and their families.
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.
This position reports to the HCS/TxHmL Program Supervisor in the IDD Waivers Unit of Utilization Review to work on the HCS/TxHmL team.
Responsibility for this position includes Routinely reviews and analyzes Intellectual Disability/Related Condition (ID/RC) data to assess the need for additional oversight. Conducts desk reviews to determine compliance with HHSC rules, policies and procedures related to enrollments, IPCs and LOC/LONs. Conducts utilization review and evaluation of proposed IPCs and makes clinical authorization decisions regarding participant eligibility and plans of care. Evaluates IPC and eligibility activities and trends to resolve technical problems, identify opportunities for improvement and to make recommendations for improvements in utilization 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 utilization review tools (e.g., review protocols, evaluation forms, etc.) in accordance with program objectives and goals. May serve as the lead to prioritize the work of colleagues by assigning provider deliverables to designated unit staff in absence of the unit supervisor. Serves as agency representative in Medicaid fair hearings. Conducts training and provides guidance to staff in the development or integration of new or revised operational procedures. Coordinates the review and evaluation of information on service delivery system methods, outputs and activities in order to identify gaps in resources and recommend improvements. 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 considerable latitude for the use of initiative and independent judgment.
Essential Job Functions
Attends work on a regular and predictable schedule in accordance with agency leave policy and performs other duties as assigned.
Provides highly complex consultative and technical assistance, including research, assessment and planning directly to management, HHSC program staff, HHSC contract management staff, local authority (LA) staff, the program provider base, advocacy groups, stakeholders, program participants and their families. (25%)
Oversees and monitors provider requirements with Individual Plans of Care (IPC) and Level of Care/Level of Need (LOC/LON) determinations. (30%)
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. (10%)
Serves as agency representative in Medicaid fair hearings. (5%)
Develops and revises utilization review tools (e.g., review protocols, evaluation forms, etc.) in accordance with program objectives and goals. (5%)
Conducts training and provides guidance to staff in the development or integration of new or revised operational procedures. (10%)
Coordinates and collaborates with program staff through participation in unit, agency and cross-agency workgroups related to unit functions and planning to analyze, develop, and implement program initiatives. (10%)
Works collaboratively across MCS to identify innovative and effective solutions for clients and staff. (5%)
Registrations, Licensure Requirements Or Certifications
Qualification as a Qualified Intellectual Disability Professional (QIDP) as defined in 42 Code of Federal Regulations 483.430(a) required.
Knowledge Skills Abilities
Ability to work collaboratively across MCS to accomplish objectives.
Able to balance team and individual responsibilities.
Knowledge of ID and other developmental disability related conditions, HCS, TxHmL, CLASS, DBMD and/or ICF/ID program rules, service array and billing guidelines, local authority functions and waiver service system.
Skill in the development and maintenance of interpersonal relationships and public speaking.
Ability to communicate effectively, both orally and in writing.
Ability to multi-task, handle stress and meet deadlines. Ability to operate computers and experience using Microsoft Office products.
Initial Screening Criteria
Qualification as a Qualified Intellectual Disability Professional (QIDP) as defined in 42 Code of Federal Regulations 483.430(a) required.
At least two years of experience working with individuals with intellectual/developmental disabilities or related conditions preferred.
Prior experience working in Texas waiver service system highly desirable.
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
Nearest Major Market: Austin
Location:
AUSTIN, TX
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.
Functional Title: Program Specialist IV
Job Title: Program Specialist IV
Agency: Health & Human Services Comm
Department: UR Wav & Comm Srvs Ran Mmt St
Posting Number: 2496
Closing Date: 01/30/2025
Posting Audience: Internal and External
Occupational Category: Community and Social Services
Salary Group: TEXAS-B-20
Salary Range: $4,263.16 - $6,779.25
Shift: Day
Additional Shift: Days (First)
Telework: Full-Time
Travel: Up to 5%
Regular/Temporary: Regular
Full Time/Part Time: Full time
FLSA Exempt/Non-Exempt: Nonexempt
Facility Location:
Job Location City: AUSTIN
Job Location Address: 701 W 51ST ST
Other Locations: Abilene; Alamo; Alice; Alpine; Alvin; Amarillo; Anahuac; Andrews; Angleton; Anson; Aransas Pass; Archer City; Arlington; Athens; Atlanta; Austin; Bacliff; Ballinger; Bandera; Bastrop; Bay City; Baytown; Beaumont; Bedford; Beeville; Bellville; Big Spring; Boerne; Bonham; Borger; Bowie; Brady; Breckenridge; Brenham; Brownfield; Brownsville; Brownwood; Bryan; Burnet; Caldwell; Cameron; Canton; Canutillo; Carlsbad; Carrizo Springs; Carrollton; Carthage; Center; Centerville; Childress; Clarksville; Cleburne; Cleveland; Coldspring; Columbus; Conroe; Copperas Cove; Corpus Christi; Corsicana; Crockett; Crosby; Crystal City; Cuero; Cypress; Daingerfield; Dallas; Decatur; Del Rio; Denton; Dickinson; Dumas; Duncanville; Eagle Pass; Eastland; Edinburg; El Paso; Elgin; Elsa; Ennis; Fabens; Falfurrias; Floresville; Fort Stockton; Fort Worth; Fredericksburg; Gainesville; Galveston; Garland; Gatesville; Georgetown; Giddings; Gilmer; Goliad; Gonzales; Graham; Granbury; Grand Prairie; Grapevine; Greenville; Hallettsville; Hamilton; Harlingen; Haskell; Hearne; Hemphill; Hempstead; Henderson; Hereford; Hillsboro; Hondo; Houston; Humble; Huntsville; Hurst; Irving; Jacksonville; Jasper; Johnson City; Jourdanton; Karnes City; Katy; Kaufman; Kerrville; Killeen; Kingsville; Kingwood; Kirbyville; La Grange; Lake Jackson; Lake Worth; Lamesa; Lampasas; Lancaster; Laredo; Levelland; Lewisville; Liberty; Linden; Littlefield; Livingston; Llano; Lockhart; Longview; Lubbock; Lufkin; Lumberton; Madisonville; Marble Falls; Marfa; Marlin; Marshall; Mcallen; Mckinney; Mercedes; Meridian; Mesquite; Mexia; Midland; Mineola; Mineral Wells; Mission; Monahans; Mount Pleasant; Mount Vernon; Nacogdoches; Navasota; New Boston; New Braunfels; Odessa; Orange; Palestine; Pampa; Paris; Pasadena; Pearland; Pearsall; Pecos; Perryton; Pharr; Pittsburg; Plainview; Plano; Pollok; Port Arthur; Port Lavaca; Presidio; Quitman; Raymondville; Refugio; Richardson; Richmond; Rio Grande City; Robstown; Rockwall; Rosenberg; Round Rock; Rowlett; Rusk; San Angelo; San Antonio; San Benito; San Juan; San Marcos; San Saba; Schertz; Seguin; Seminole; Seymour; Sherman; Silsbee; Sinton; Snyder; Socorro; Sonora; South Houston; Stephenville; Sugar Land; Sulphur Springs; Sweetwater; Taylor; Temple; Terrell; Texarkana; Texas City; The Woodlands; Tomball; Trinity; Tyler; Uvalde; Van Horn; Vernon; Victoria; Waco; Washington; Watauga; Waxahachie; Weatherford; Webster; Weslaco; Wharton; Wichita Falls; Woodville; Zapata
MOS Codes
16GX,60C0,611X,612X,63G0,641X,712X,86M0,86P0,88A0,88B0,8U000,OS,OSS,PERS,YN,YNS
Program Specialist IV The Texas Health and Human Services Commission (HHSC) Medicaid CHIP Services (MCS) department seeks a highly qualified candidate to fill the position of Program Specialist IV. 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 oversight and monitoring of provider requirements with Individual Plans of Care (IPC) and Level of Care/Level of Need (LOC/LON) determinations.
The Program Specialist IV position completes highly complex consultative and technical assistance, including research, assessment and planning directly to management, HHSC program staff, HHSC contract management staff, local authority (LIDDA) staff, the Home and Community-based Services (HCS), Texas Home Living (TxHmL), Community Living Assistance and Support Services (CLASS), Deaf Blind with Multiple Disability (DBMD) and Intermediate Care Facility (ICF/ID) provider base, advocacy groups, stakeholders, program participants and their families.
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.
This position reports to the HCS/TxHmL Program Supervisor in the IDD Waivers Unit of Utilization Review to work on the HCS/TxHmL team.
Responsibility for this position includes Routinely reviews and analyzes Intellectual Disability/Related Condition (ID/RC) data to assess the need for additional oversight. Conducts desk reviews to determine compliance with HHSC rules, policies and procedures related to enrollments, IPCs and LOC/LONs. Conducts utilization review and evaluation of proposed IPCs and makes clinical authorization decisions regarding participant eligibility and plans of care. Evaluates IPC and eligibility activities and trends to resolve technical problems, identify opportunities for improvement and to make recommendations for improvements in utilization 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 utilization review tools (e.g., review protocols, evaluation forms, etc.) in accordance with program objectives and goals. May serve as the lead to prioritize the work of colleagues by assigning provider deliverables to designated unit staff in absence of the unit supervisor. Serves as agency representative in Medicaid fair hearings. Conducts training and provides guidance to staff in the development or integration of new or revised operational procedures. Coordinates the review and evaluation of information on service delivery system methods, outputs and activities in order to identify gaps in resources and recommend improvements. 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 considerable latitude for the use of initiative and independent judgment.
Essential Job Functions
Attends work on a regular and predictable schedule in accordance with agency leave policy and performs other duties as assigned.
Provides highly complex consultative and technical assistance, including research, assessment and planning directly to management, HHSC program staff, HHSC contract management staff, local authority (LA) staff, the program provider base, advocacy groups, stakeholders, program participants and their families. (25%)
Oversees and monitors provider requirements with Individual Plans of Care (IPC) and Level of Care/Level of Need (LOC/LON) determinations. (30%)
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. (10%)
Serves as agency representative in Medicaid fair hearings. (5%)
Develops and revises utilization review tools (e.g., review protocols, evaluation forms, etc.) in accordance with program objectives and goals. (5%)
Conducts training and provides guidance to staff in the development or integration of new or revised operational procedures. (10%)
Coordinates and collaborates with program staff through participation in unit, agency and cross-agency workgroups related to unit functions and planning to analyze, develop, and implement program initiatives. (10%)
Works collaboratively across MCS to identify innovative and effective solutions for clients and staff. (5%)
Registrations, Licensure Requirements Or Certifications
Qualification as a Qualified Intellectual Disability Professional (QIDP) as defined in 42 Code of Federal Regulations 483.430(a) required.
Knowledge Skills Abilities
Ability to work collaboratively across MCS to accomplish objectives.
Able to balance team and individual responsibilities.
Knowledge of ID and other developmental disability related conditions, HCS, TxHmL, CLASS, DBMD and/or ICF/ID program rules, service array and billing guidelines, local authority functions and waiver service system.
Skill in the development and maintenance of interpersonal relationships and public speaking.
Ability to communicate effectively, both orally and in writing.
Ability to multi-task, handle stress and meet deadlines. Ability to operate computers and experience using Microsoft Office products.
Initial Screening Criteria
Qualification as a Qualified Intellectual Disability Professional (QIDP) as defined in 42 Code of Federal Regulations 483.430(a) required.
At least two years of experience working with individuals with intellectual/developmental disabilities or related conditions preferred.
Prior experience working in Texas waiver service system highly desirable.
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
Nearest Major Market: Austin
Salary : $4,263 - $6,779
