HCBS Compliance Analyst

TX-HHSC-DSHS-DFPS•Austin, TX

1d•Hybrid

About The Position

The Texas Health and Human Services Commission (HHSC) Medicaid and CHIP Services (MCS) division seek a highly qualified candidate to fill the position of Compliance Analyst IV. The Compliance Analyst reports to the Home and Community-Based Services (HCBS) Quality Manager of the Quality Reporting Unit and works within the Quality Data Analytics and Reporting Department. The Compliance Analyst performs highly complex (senior-level) compliance analysis work involving interpreting, monitoring, and reporting on adherence to applicable federal, state, and local laws and regulations around Home and Community-based Services. Works under limited supervision, with considerable latitude for the use of initiative and independent judgment. MCS is driven by its mission to deliver quality, cost-effective services to Texans. This position makes a significant contribution to MCS’s mission by using data-driven evidence-based approaches to hold Medicaid and CHIP service providers and Managed Care Organizations accountable, ensure access to high-quality care, and drive quality-based innovation. The ideal candidate thrives in an environment that emphasizes teamwork to achieve goals, excellence through high professional standards and personal accountability, curiosity to continuously grow and learn, critical thinking for effective execution, and integrity to do things right even when what is right is not easy.

Requirements

Knowledge of relevant federal and state rules and regulations related to Medicaid, Home and Community-Based Services, or long-term services and supports.
Knowledge of contract and compliance monitoring.
Knowledge of statistical concepts, sampling methods, and models.
Skill in conducting data searches and evaluating large amounts of data.
Skill in using data management programs to run queries.
Skill in using applicable data visualization software to communicate compliance summaries and recommendations.
Skill in preparing concise and accurate reports for agency management and staff.
Skill in preparing and presenting reports for agency management and other staff.
Ability to identify problems, evaluate alternatives, and implement effective solutions.
Ability to maintain effective working relationships and communicate effectively with other teams and departments.
Ability to oversee and/or supervise the work of others.
Graduation from an accredited four-year college or university with major coursework in business administration, public administration, finance, accounting, computer science, statistical analysis, mathematics, research methodology, or a related field is generally preferred.
Experience with Medicaid, Home and Community-Based Services, or long-term services and supports data.

Responsibilities

Compiles and analyzes HCBS data from various sources and databases to verify state compliance with technical specifications, state and federal laws, rules, and regulations related to long-term care services and supports. (25%)
Develops accurate reports and visual summaries to communicate audit results and makes recommendations on improving HCBS outcomes and compliance across the state. (25%)
Performs advanced auditing work of HCBS records. Creates compliance review and audit guidelines. Trains internal and external stakeholders on the audit process. (15%)
Develops timelines and defines the scope of compliance review work. Reviews contracts and other legal documents related to compliance reviews. (15%)
Submits reporting results and findings as part of the HCBS Quality Measure Set reporting to the Centers for Medicare and Medicaid Services (CMS) in accordance with CMS-2442-F requirements. Presents reporting results to internal and external stakeholders. (15%)
Performs related work as assigned. (5%)

Benefits

comprehensive benefits package includes 100% paid employee health insurance for full-time eligible employees
defined benefit pension plan
generous time off benefits
numerous opportunities for career advancement
Excellent health benefits
Lifetime monthly retirement annuity
Generous time off benefits
Leadership commitment to invest in and foster your professional growth or knowledge of the Texas Medicaid program and your career advancement.
Having a profound impact on the lives of thousands of Medicaid clients that depend on Medicaid services throughout Texas.
Being on the ground level of healthcare quality implementation, including the opportunity to work closely with stakeholders such as federal partners, providers, advocates, managed care organizations, and other healthcare contractors.
Being part of a team at the forefront of interpreting, implementing, and developing quality initiatives that have a statewide impact.
The opportunity to learn and engage with multiple domains of the healthcare delivery system, including managed care, fee-for-service, federal/state Medicaid partnerships and other activities related to the administration of the Medicaid program.