Job Information
HEALTH AND HUMAN SERVICES COMMISSION HCBS-AMH QM Specialist in AUSTIN, Texas
Job/Position DescriptionProgram Specialist V works under the general direction of the Behavioral Health Medicaid Programs Contracts and Quality Management Manager or her designee with considerable latitude for use of initiative and independent judgment. Specialist functions as part of a team of staff specifically designated to work on oversight and management of the Medicaid State Plan Amendment, 1915(i) program, called Home and Community-Based Services - Adult Mental Health (HCBS-AMH) for persons with serious mental illness. The HCBS-AMH program provides an array of services appropriate to each person's needs to enable them to live and experience a successful tenure in their community. Services are designed to support long-term recovery from mental illness and to divert placement in correctional facilities, hospital emergency departments and psychiatric hospitalization. Specialist will perform advanced (senior-level) consultative services and technical assistance work that involves working with community-based providers. Duties may include but are not limited to: develop policies and procedures, provide technical assistance and monitor provider compliance, monitor client and provider complaints, including critical incidents. Coordinate and completes quality management activities including collecting and reporting performance measures, monitoring utilization patterns of clients and providers, and investigating clinical quality issues and completes all required reports and related documentation. Specialist will work closely with the Texas Health and Human Services (HHSC) Quality Management and Decision Support Units, and Centers for Medicare and Medicaid Services (CMS) to ensure compliance with the waiver and contract requirements, develop and implement program goals and objectives, and ensure project course corrections when needed. Works closely with the mental health providers contracted to provide waiver program services to resolve problems and discuss program effectiveness.This position is eligible for telework in accordance with HHSC Telework policy. and#160;Essential Job FunctionsAttends work on a regular and predictable in accordance with agency leave policy and performs other duties as assigned.Provides complex consultative services and technical assistance to plan, implement, and monitor program services. Works closely with community-based providers and local mental health authorities. (15%) Develops policies and procedures related to implementation and monitoring of program services. Ensures that local mental health authorities and other community-based providers receive training on new policies and procedures, and that periodic monitoring takes place. (15%) Conducts and coordinates desk and onsite reviews to determine compliance with program requirements, laws, regulations, policies, and procedures. Analyzes reviews of program services and develops corrective action plans to improve effectiveness, if needed. Communicates those findings, orally and in writing, to a wide variety of audiences, including HHSC and CMS. (15%) Ensures that there is continuous quality monitoring program in place to ensure that identified problems are acted upon and resolved promptly. Determines when course corrections are required when program or program provider is not achieving goals or objectives. (10%) Collects, organizes, analyzes, and prepares material in response to requests for information from internal and external stakeholders. Synthesizes complex information for presentation to a https://jobshrportal.hhsc.state.tx.us/ENG/CareerPortal/job_profile.cfm?szOrderID=590988 Copy the URL in the preceding sentence to an Internet Explorer browser to apply to the job directly through the Texas Health and Human Services Career Portal.