Texas Health and Human Services · 22 hours ago
Enforcement Compliance Reviewer
Austin, TX
Full-time
Hybrid
Mid Level
$4,523/mo - $7,253/moTexas Health and Human Services Commission (HHSC) is dedicated to positively impacting the lives of Texans. The Enforcement Compliance Reviewer will analyze and review compliance with state licensing and certification standards in health services, ensuring adherence to regulations and quality management of assignments.
Health Care
No H1B
Responsibilities
Performs review and analysis of Day Activity Health Services (DAHS), Home and Community Support Services Agencies (HCSSA), Individualized Skills and Socialization (ISS), and Prescribed Pediatric Extended Care Centers (PPECC) state licensing violations. Performs review and analysis of Home and Community-based Services (HCS) and Texas Home Living (TxHmL) state certification principle violations. Implements the Issue, Rule, Application and Conclusion (IRAC) method to determine whether the documented evidence and packets supports a determination of noncompliance and whether violations warrant enforcement action
Performs quality management of assignments, maintains systems for follow-up and tracking of assignments, and performs data entry in applicable program databases including but not limited to TULIP, SharePoint, Access
Conducts Informal Dispute Resolution (IDR) reviews of State Licensing violations. Communicates with IDR requestors for clarifications and additional information as needed. Prepares detailed narrative of rationale and decision. Utilizes all resources, peers, and literature for clarification
Reviews Opportunity to Show Compliance (OSC) packets to determine if the recommended action is warranted and supportable. Prepares detailed narrative of rationale and decision. Utilizes all resources, peers, and literature for clarification
Communicates with regional and state office staff to provide consultation, interpretation, guidance, and clarification of DAHS, HCSSA, ISS, PPECC, HCS, and TxHmL standards, principles, and rules; and participates in work groups representing DAHS, HCSSA, ISS, PPECC, HCS, and TxHmL enforcement, as needed
Attends and completes all required trainings applicable to the DAHS, HCSSA, ISS, PPECC, HCS, and TxHmL programs. Attends work on a regular and predictable schedule and performs other duties as assigned
Attends enforcement case pre-hearing conferences and hearings related to enforcement actions of DAHS, HCSSA, ISS, PPECC, HCS, and TxHmL
Qualification
Required
Has broad knowledge of Day Activity Health Services (DAHS); Home and Community Support Services Agencies (HCSSA); Individualized Skills and Socialization (ISS); Prescribed Pediatric Extended Care Centers (PPECC); and/or Home and Community-based Services (HCS) and Texas Home Living (TxHmL) programs
Has broad knowledge of Medicare, Medicaid, and/or State Licensing regulations relating to DAHS, HCSSA, ISS, and PPECC programs; and/or certification rules relating to HCS and TxHmL programs
Has general understanding of disease processes and treatments for pediatrics, adults, and geriatrics
Has broad knowledge of intellectual and developmental disabilities
Applies analytical and critical thinking skills using the Issue, Rule, Application and Conclusion (IRAC) method in the review of state licensing violations for DAHS, HCSSA, ISS, and PPECC to ensure accuracy pursuant to state licensing standards
Applies analytical and critical thinking skills using the Issue, Rule, Application and Conclusion (IRAC) method in the review of state certification principle violations for HCS and TxHmL to ensure accuracy pursuant to state certification standards
Performs Informal Dispute Resolution (IDR) reviews of state licensing violations and prepares detailed narrative of decisions and rationales
Performs review of Opportunity to Show Compliance (OSC) packets to determine if enforcement action is supportable and warranted
Provides consultation, interpretation and or clarification of rules and standards relating to DAHS, HCSSA, ISS, and PPECC
Provides consultation, interpretation and or clarification of rules and principles relating to HCS and TxHmL
Participates in work groups and meetings related to DAHS, HCSSA, ISS, PPECC, HCS, and TxHmL
Performs quality management of assignments including proofing, follow-up, tracking and monitoring, and data entry in applicable program databases including but not limited to TULIP, SharePoint, Access
Attends enforcement case pre-hearing conferences and hearings related to enforcement actions of DAHS, HCSSA, ISS, PPECC, HCS, and TxHmL
Must be able to communicate on a complex and professional level with others, internally and externally
Must attend and complete all required training related to the DAHS, HCSSA, ISS, PPECC, HCS, and TxHmL programs
Knowledge of the administration and provision care under Day Activity Health Services (DAHS); Home and Community Support Services Agencies (HCSSA); Individualized Skills and Socialization (ISS); Prescribed Pediatric Extended Care Centers (PPECC); and/or Home and Community-based Services (HCS) and Texas Home Living (TxHmL) programs or other long-term care programs
Knowledge of Medicare, Medicaid, and/or state licensing rules relating to DAHS, HCSSA, ISS, and PPECC, or other long-term care programs; and/or certification rules relating to HCS and TxHmL programs
Knowledge of regulatory activities including inspections/surveys, investigations, and/or enforcement
Ability to gather, organize, analyze facts; compile and prepare reports; effectively enter and track data, develop and evaluate policies and procedures and initiate modifications as needed
Ability to perform work independently and operate effectively within established guidelines and timeframes
Ability to establish and maintain effective working relationships with managers, team members, internal and external stakeholders
Ability to communicate effectively both orally and in writing
Skill in operating computers and in using computer software
Experience in long-term care regulatory services
Experience in DAHS, HCSSA, ISS, PPECC, HCS or TxHmL programs
Experience in surveys, investigations, or enforcement of long-term care regulatory services
Experience in long term care facilities
Graduation from an accredited college or university with a degree in a related field of health care, social services, or legal services
Experience in regulatory services may be substituted for education on year-to-year basis
Benefits
100% paid employee health insurance for full-time eligible employees
A 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.
Founded in 1907
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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