Website State Of Texas
Serves as a specialist in the Program Support Unit (PSU) performing moderately complex tasks related to managed care Long Term Services and Supports (LTSS). Work involves frequent contact with case managers in Community Care Services Eligibility (CCSE), individuals enrolled in or applying for 1915(c) waiver services, service providers, LTSS MCOs, relocation specialists, nursing facility staff, the public, Health and Human Services Commission.
- Attends work on a regular and predictable schedule in accordance with agency leave policy and performs other duties as assigned.
- As appropriate, contact the appropriate person to assist with resolution of obstacles and document the reason for the delay.
- Interpret policy and coordinate activities related to transitioning individuals from the nursing home to the community, handling the transition of children aging out of MDCP services, and people who transition in and out of a Medicaid 1115 Waiver program.
- Develop, coordinate, and explain Medicaid 1115 waiver programs to applicants and members. Authorize or deny waiver services, by sending approval or denial notices to applicants, members and other key parties.
- Validate eligibility in appropriate systems. Register waiver program eligibility in appropriate systems, authorize MCOs to begin approved services. Coordinate with MEPD staff for enrollment in a Medicaid 1115 Waiver program.
- Perform interest list activities such as confirming contact information is accurate, mailing enrollment packets, determining which MCO individuals want to enroll with, making follow-up contacts as needed, and ensuring individuals’ wish to be assessed for a Medicaid 1115 Waiver program.
- Knowledge of Medicaid 1115 waiver programs, policies and procedures.
- General knowledge of community and government service delivery systems, case guidelines, regulations and policies, interviewing techniques, mental illness and the emotional components of physical illness, individuals’ needs associated with disabilities, and community welfare resources.
- Skill in communicating effectively orally and in writing with all types of people, in all types of situations.
- Ability to convey instructions and explanations to individuals and key parties, to negotiate available services, and to train others.
- Ability to operate computer equipment and be proficient in the use of Outlook, Excel, Word, as well as the ability to gain a general understanding of various state software programs, e.g., TIERS, SAS and CSIL.
- Skill in managing stress in high-profile situations while maintaining a professional demeanor. Skill in identifying systemic problems and ways to resolve same.
- Skill and ability to multi-task under pressure. Skill and ability to manage workload effectively to meet goals and objectives of Medicaid 1115 waiver programs and meet timeframes.
- Ability to identify potential problems that would have a negative impact on service delivery and act proactively to prevent the problem.
- Ability to establish priorities according to relative importance and deadlines, set goals and manage time efficiently.
Company: State Of Texas
Vacancy Type: Full Time
Job Location: Houston, TX, US
Application Deadline: N/A