Texas Health and Human Services · 2 hours ago
Contract Specialist IV
San Antonio, TX
Contract
Hybrid
Mid, Senior Level
$4,801/mo - $7,761/mo
4+ years expTexas Health and Human Services Commission (HHSC) is committed to creating a positive impact in the lives of Texans. They are seeking a Contract Specialist IV to perform program and fiscal contract monitoring reviews for Medicaid Waiver Programs, ensuring compliance with guidelines and providing consultative services to various stakeholders.
Health Care
No H1B
Responsibilities
Prepares, leads and conducts contract and fiscal compliance monitoring reviews of contracted CLASS and DBMD providers to determine compliance with program guidelines, rules, laws and/or statutes. Works with program staff in determining trends and resolving technical problems. Responsible for completing sample selection and all other functions necessary for monitoring and review activity. Ensures any correspondence or forms are accurate and concise. Provides accurate information related to recovery of identified overpayments. Communicates effectively with internal and external stakeholders regarding provider correspondence items (Demand Letters, Payment Plans, etc.) Accurately evaluates providers’ eligibility for payment plans
Prepares written reports and tracks CLASS and DBMD performance measurements. Provides tracking for all corrective action plans and recoupments including reporting and complies with HHSC’s and internal provisions of tracking, letters, and communications. Effectively communicates with internal and external stakeholders
Assists in preparing justifications for the implementation of procedural or policy changes. Assists in the review of CLASS and DBMD program area functions and operations, in identification of areas of needed changes, and in the development of plans to improve or initiate programs or to address areas of concern. Assists in analyzing the business practices related to fiscal and contract compliance to develop corrective action. Develops and performs quality assurance oversight activities for the provider monitoring unit as assigned
Acts as liaison with individuals receiving services, agencies and internal program staff to explain and provide technical assistance on agency and program statutory requirements for CLASS and DBMD. Collaborates on analysis and documentation of CLASS and DBMD program policies. Provides technical assistance and training via telephone and in person to CLASS and DBMD providers regarding the billing guidelines and Texas Administrative Code to facilitate compliance with contract requirements. Prepares justifications for procedural changes pertaining to CLASS and DBMD. Prepares administrative reports, studies, and specialized research projects
May recommend and coordinate activities to produce more effective CLASS and DBMD programs. May develop policy and procedure manuals
Produces high quality products within timeframes specified by supervisor. Identify and request training appropriate to job functions, as needed. May train others. Performs related work as assigned
Qualification
Required
Graduation from an accredited four-year college or university with major course work in a human service-related, business, or legal field, plus 4 years relevant work experience conducting auditing, compliance oversight, case management, or fiscal monitoring
Experience in conducting auditing, financial oversight, fiscal or contract compliance monitoring, or other types of relevant oversight activities
Experience Developing And Implementing Policies And Procedures
Ability to travel at least 50% of the time with some travel including overnight stays
To maintain employment as a Contract Specialist, this position will require an applicant to obtain specialized certification as a Certified Texas Contract Manager (CTCM). If not currently a CTCM, the selected candidate must obtain CTCM certification within 12 months of hire date unless otherwise approved by supervisor and maintain certification throughout employment
Position requires a valid Texas driver's license
Intermediate skill level using MS Excel, Word, and PowerPoint, required
Preferred
Experience with 26 TAC Chapter 52 Community Services programs, and interpretation of an organization's policies and procedures, guidelines, handbooks, laws, rules and/or statutes
Qualified Intellectual Disability Professional (QIDP) preferred
Benefits
100% paid employee health insurance for full-time eligible employees
Defined benefit pension plan
Generous time off benefits
Numerous opportunities for career advancement
Company
Texas Health and Human Services
Texas Health and Human Services is an agency that focuses on improving health, safety and well-being.
10001+ employees
Funding
Current Stage
Late StageLeadership Team
Dr. Napoleon Broughton
Chief Executive Officer: Life Enhancement Solutions
John F. Palermo
CTO Strategic Analyst VI
Recent News
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