Provider Relations Representative

About the role

The Program Specialist IIA provides consultative services and technical assistance to program staff, community organizations, and Texas Health Steps (THS) providers. They serve as a THS Provider Representative and liaison to provide technical assistance on THS specifics and requirements.

Responsibilities

• Provider Support (45%): Provides education and updates to retain existing and new medical, dental, and case management providers; conduct education activities to community stakeholders regarding THS and Medicaid Services; makes consultative to providers to discuss program issues, updates about programs, conduct trainings and/or assist providers with interpreting program policies and procedures; collaborates, communicates and assists with Managed Care Organizations (MCO’s) and Texas Medicaid (TMHP) for providers regarding billing issues; escalates complex problems to central office timely to meet the needs of the provider; assists medical and dental providers in the resolution of client related problems with community resources for referrals.
• Program Support (25%): Assists with compiling, analyzing and reporting of the THS activities to meet regional program goals and objectives and reporting to Program Manager; may assist Providers with consumer complaints and corrective action plans with guidance and interpretation; ensures that provider information is updated annually in appropriate database as determined by central office or regional needs.
• Trainings & Presentations (15%): Contacts enrolled medical and dental THS providers at a minimal annually, to provide technical assistance with an on-site visit that promotes education, outreach and training; identifies provider training needs and offers appropriate training and educational sessions; maintains Vision & Hearing Trainer Certification and conducts provider trainings as requested.
• Community & Outreach Activities (10%): Participates in community activities for the promotion and marketing of THS program; contacts potential medical, dental or CPW providers to explain the THS program and works collaboratively with public health partners to develop strategies to increase number of THS providers and retain current providers; attends and participates in regional and statewide THS meetings for program planning.
• Adherence to Policy and Other Duties as Assigned (5%): Actively participate and serve in a supporting role to meet the agency’s obligations for disaster response and/or recovery or Continuity of Operations (COOP) activation; maintains an acceptable driving record, a valid class C Texas driver's license; works in teams and takes direction from supervisors; establishes and maintains effective work relationships with internal and external clients and colleagues; develops training materials; works independently with minimum supervision; interprets and applies program policy; works independently with minimum supervision; completes all Public Health Emergency Response, COOP, and other state mandated trainings; reports time, labor and travel information in a timely manner; other duties as assigned by program manager including special assignments.

Requirements

• Bachelor's degree in human services, public health, education, social work or related field from an accredited college or university.
• Experience working in the Healthcare industry/field. 2 years preferred.
• Experience conducting training and/or providing technical assistance. 2 years preferred.
• Experience in conducting/coordinating projects, events and activities in the community. 2 years preferred.
• Experience in the use of computers and related equipment, including the use of Office Suite, Spreadsheets, databases and presentation software required.
• Experience working with healthcare providers, community organizations or external stakeholders. 2 years preferred.

Qualifications

• Must possess a valid Class C Texas driver’s license, or equivalent license from another state.
• Working knowledge of Human Resources, Information Technology, Administrative Policy and Program Policy.
• Completes all Public Health Emergency Response, COOP, and other state mandated trainings.

Skills

• Knowledge of Health & Human Service Medicaid programs, Medicaid Managed Care and Medicaid Managed Care Organizations.
• Knowledge of public health and public health practices.
• Knowledge of recommended medical developmental screenings for children birth to 20 years.
• Knowledge of recommended dental screenings for children birth to 20 years.
• Public speaking skills.
• Oral and written communication skills.
• Adult training methods.
• Analyzing and devising solutions for problems identified.
• Interpreting and researching policies, procedures and regulations.
• Working with community agencies, groups or coalitions.
• Working independently, to organize workload, establish priorities and complete assigned tasks.
• Microsoft Office Products.

Benefits

DSHS offers insurance coverage and other benefits available through the State of Texas Group Benefits Plan administered by the Employee Retirement System of Texas (ERS).