Medicaid Program Policy Analyst

Brief Job Description

The Program Policy team within the Medicaid and CHIP Services (MCS) Office of Policy is seeking a Program Specialist V to serve as a policy analyst and subject matter expert on a variety of program policy topics related to Medicaid and CHIP services and managed care. Duties involve performing advanced consultative and technical work related to the analysis, planning, development, implementation, and maintenance of managed care policy. Policy area examples include but are not limited to: the statewide STAR program, hospice services, service coordination, targeted case management, non-emergency medical transportation, Federally Qualified Health Centers (FQHCs), complaints and appeals, and services for justice-involved youth.

Essential Job Functions

• Collaborates with other areas of MCS and HHSC to plan, develop, implement, monitor, interpret, and evaluate Medicaid programs, policies, MCO contract requirements, business rules, administrative rules, waivers, and state plan. Evaluates MCO compliance with program policies and procedures, contract requirements, statutes, rules, and takes corrective action if needed.
• Plans, monitors, and evaluates the implementation of state and federal legislation and regulations. Analyzes state legislation, federal legislation, and federal rules to evaluate their impact on MCS and stakeholders, including MCOs, service providers, and members.
• Establishes, facilitates, participates in, and develops agendas for relevant workgroups and committees, including inter-agency workgroups and committees. Coordinates and provides requested training to internal staff and external entities.
• Prepares high quality written documents such as project updates, reports, PowerPoint presentations, communications to stakeholders and contractors, executive memos, policy and project summaries, legislative reports, administrative rules, waivers, and state plan amendments.
• Other duties as assigned.

Knowledge, Skills, and Abilities

• Knowledge of: Federal and state Medicaid and CHIP laws and regulations; Government organization and administration; Program issues related to Medicaid services for children and adults; Principles of health and human services policy and planning; State of Texas legislative processes.
• Skills in: Analyzing, evaluating, and interpreting complex federal and state legislation, program, policy, and operations issues; Project management policy analysis, and performing policy research; Synthesizing, analyzing, and evaluating highly complicated and technical information; Translating policy and technical information into easily understandable and concise documents and oral presentations; Developing creative and workable solutions to complex problems and policy issues; and Facilitating stakeholder and different workgroup meetings.
• Ability to: Develop, amend, and interpret program policies, rules, and contract requirements related to Medicaid and CHIP Services; Research, gather, assemble, correlate, and analyze facts and devise solutions based on the information available; Work with a team under pressure, negotiate among multiple parties, resolve conflicts; Exercise judgment and work independently with minimum supervision; Work cooperatively as a team member in a fast-paced, deadline-oriented environment; Establish and maintain effective working relationships with various levels of personnel in government entities; Use Microsoft Office Suite applications such as Outlook, Teams, Word, and Excel; Communicate effectively orally and in writing, including the ability to adjust communications to fit the intended audience; Work with diverse groups of people, including stakeholders, who have a variety of opinions.

Initial Selection Criteria

• Candidate must meet one of the following:
• A high school diploma and at least five years of full-time work experience in a health and human services field;
• A bachelor’s degree from an accredited four-year college or university and at least one year of full-time work experience in a health and human services field;
• A master’s degree from an accredited college or university in public health, public administration, public affairs, social work, or closely related field.

Additional Information

The position is located in Austin and requires regular in-office attendance, with some opportunity for telework.