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Company: Texas Health and Human Services
Location: Austin, TX
Career Level: Associate
Industries: Government Administration

Description


Program Specialist III will provide highly complex consultative and technical assistance, including research, assessment and planning directly to management, IDD Program Eligibility and Support (IDD PES) department colleagues and HHSC staff from other agency organizational areas, Local Intellectual and Developmental Disability Authority (LIDDA) staff, Community Living Assistance and Support Services (CLASS), and Community First Choice (CFC) Non-Waiver, advocacy groups, stakeholders, program participants and their families. Work involves Level of Care (LOC) eligibility determinations for individuals who receive services in the CLASS Waiver Program and Community First Choice (CFC) Non-Waiver program. Work also involves the oversight and monitoring of provider requirements with enrollment activities, such as initial Individual Plans of Care (IPC) and Level of Care(LOC) determinations. 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 program enrollment, including IPCs and LOCs. Conducts initial ID/RC and CLASS proposed enrollment IPC reviews to make authorization decisions regarding participant eligibility and plan of care approvals. Evaluates IPC and eligibility activities and trends to resolve technical problems, identifies opportunities for improvement and makes recommendations for improvements in 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 review tools (e.g., review protocols, evaluation forms, etc.) in accordance with program objectives and goals. Serves as agency representative to present the state's action 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.
 


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