Medical and Dental Benefits Policy Manager

Health & Human Services Comm View Company Profile

The Medical and Dental Benefits Policy Manager (Manager V) in Texas Medicaid reports to the Director of Medical and Dental Benefits Policy in the Office of Policy. This position performs highly advanced (senior level) managerial work administering daily operations and activities related to the development of clinical policy for Medicaid medical benefits. The work conducted and overseen by this position is complex, very technical, requires high-level analytical skills, and involves facilitation and negotiations with other areas within the Division, HHS, the claims administrator contractor, and vendors. The position must be able to synthesize evidence based clinical information from a variety of sources (current practice, other states, and federal guidance) when providing direction to staff and must have outstanding interpersonal skills. The Manager V works under the general direction of the Medical Benefits Policy Director with extensive latitude for the use of initiative and independent judgment and performs other duties as assigned. Essential Job Functions: EJF 1 (30%) Plans, assigns, and supervises the work of staff in the development of Texas Medicaid medical benefits. Provides direction to staff for the development of medical policy to ensure staff performs assigned tasks using established, evidence-based resources, using established processes and within established time frames. Reviews and approves all work product. Organizes and develops materials such as papers, presentations, and reports in response to requests for program and clinical information from providers, stakeholders, legislative or executive staff, and others. EJF 2 (30%) Facilitates communication within the Office of Policy and Program, Office of Medical Director, and other areas within HHS and other agencies. Assists with negotiations and problem-solving to ensure quality of work and that work is performed within time frames. Identifies areas of needed change and makes recommendations to improve operations. Informs the Director of activities and emerging issues and proposes remedies. EJF 3 (20%) Leads or participates in agency workgroups as necessary for successful implementation of projects, policies, and initiatives. Works with and speaks to community and professional groups, other HHSC programs, other state agencies, legislative staff, and public stakeholders, to provide information, technical assistance, identify needs, cultivate professional relationships, and resolve issues. Makes presentations with recommendations to executive staff and other leaders. Approves staff responses to legislative, provider, and stakeholder requests for information. EJF 4 (15%) Ensures staff is trained to complete assigned work. Motivates staff through positive and constructive feedback, fostering collaboration among and between teams, and communicates with staff regarding work performance and expectations. Assists staff in constructively dealing with change, as appropriate. Establishes goals and standards for the team and develops measurement tools for determining progress for meeting goals/standards, such as performance evaluations, progress plans, and spreadsheet tracking. Performs human resource requirements including approval of time and leave, recruiting potential staff, interviewing, and hiring. EJF 5 (5%) Performs other duties as assigned. Knowledge Skills Abilities: The candidate must have knowledge of the Medicaid and CHIP programs as well as other public health services programs; knowledge of public administration and management techniques; and knowledge of analysis processes and program planning and implementation. The candidates must have skill in researching clinical, scholarly, academic, and peer-reviewed literature; assembling and analyzing facts to devise solutions to problems; written and oral communication, including the ability to make public presentations, write technical information in an understandable format, and produce sophisticated research reports; and in developing and evaluating policies and procedures. The candidate must have skills in managing competing priorities and establishing and maintaining effective working relationships. Candidates must have skill using personal computer application software such as Microsoft Word, Power Point, Excel, Microsoft Project, or similar programs. Candidates must be able to communicate effectively; lead and motivate staff; lead project teams; and work with multiple stakeholders. Candidate must have effective interpersonal communication skills and ability to collaborate across a variety of business areas and with staff at multiple levels of experience and expertise. Candidates must be able to identify problems, evaluate alternatives, and propose effective solutions; effectively plan, assign, and supervise the work of others; work cooperatively as a team member in a rapid-paced, deadline-oriented environment; and organize resources to achieve desired outcomes. Candidates must have the ability to manage multiple staff at multiple levels of experience and expertise; the ability to exercise judgment and work independently with minimum supervision; and the ability to organize and develop work plans and adhere to strict deadlines. Registration or Licensure Requirements: Initial Selection Criteria: A bachelorxe2x80x99s degree from an accredited university or college is required. Masterxe2x80x99s degree preferred in public health, nursing, health policy, biology or other social/behavioral health field or 4 yearsxe2x80x99 experience in area that provided equivalent experience. Supervisory or team lead experience required. Strong written skills required. Experience with healthcare, or public health programs, or government policy or regulation required. Additional Information: Salary Note: The posted salary range reflects the minimum and maximum allowable by state law. Any employment offer is contingent upon available budgeted funds. The offered salary will be determined in accordance with budgetary limits and the requirements of HHSC Human Resources Manual. Interview Candidates: Interview candidates will be asked to submit two writing samples and may be asked to complete an in-basket exercise. MOS Code: There are no direct military occupation(s) that relate to the responsibilities, and registration or licensure requirements for this position. All active duty, reservists, guardsmen, and veterans are encouraged to apply if they meet the qualifications for this position. HHS agencies use E-Verify. You must bring your I-9 documentation with you on your first day of work. In compliance with the Americans with Disabilities Act (ADA), HHS agencies will provide reasonable accommodation during the hiring and selection process for qualified individuals with a disability. If you need assistance completing the on-line application, contact the HHS Employee Service Center at 1-888-894-4747. If you are contacted for an interview and need accommodation to participate in the interview process, please notify the person scheduling the interview. Top 10 Tips for Success when Applying to Jobs at HHSC and DSHS

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