Texas Health Steps Provider Relations Representative

TX-HHSC-DSHS-DFPS • Temple, TX

1d • Onsite

About The Position

Under the direction of the Texas Health Steps (THSteps) Program Supervisor, serves as provider relations specialist for the THSteps aspect of the program. Participates in the planning, development, implementation, and monitoring of strategies to support and advance the THSteps program. Serves as liaison for THSteps providers, Medicaid claims contractors, Managed Care Organizations (MCOs), and other relevant stakeholders.  

Activities include: efforts to recruit, retain, and refer medical and dental providers for participation in the THSteps program; providing consultation to resolve provider enrollment and billing issues; policy clarification; technical assistance; and developing and delivering educational presentations to relevant stakeholders. Works under general supervision, with limited latitude for the use of initiative and independent judgment. Performs other duties as assigned. Member of the Incident Command Structure (ICS) in response to public health emergencies. Employee must be able to independently travel throughout the State of Texas to complete essential job functions. in response to public health emergencies. Must comply with HHS, DSHS, and Texas Department of Public Safety applicable policies/procedures/standards. Collaborates with agency/program staff and actively participates in Community Resource Coordination Groups (CRCG), community organizations and coalitions. Completes administrative duties, monthly reports, special assignments and work activities in a professional and timely manner. Works collaboratively with public health staff in the event of a regional or state disaster. Works under minimum supervision with considerable latitude for the use of initiative and independent judgment.

Requirements

• Bachelor's degree in human services, public health, education, social work or related field from an accredited college or university. Experience may be substituted for education on a year-for-year basis
• Experience working with populations served (individuals and/or community groups).
• Must possess a valid class C Texas driver's license or equivalent from another state
• Knowledge of: THSteps program policy, requirements, and procedures; marketing strategies; Medicaid programs and the client eligibility process; related children's health programs such as CHIP, CSHCN-SP, SSI; healthcare delivery systems; Health Insurance Portability and Accountability Act (HIPAA); agency policies and procedures; quality assurance and technical assistance practices.
• Skilled at: planning, prioritizing, and organizing workload; developing, compiling, and analyzing reports and action plans; problem resolution and effective decision-making; developing and delivering presentations and trainings; use of software applications, including Microsoft office products.
• Ability to: communicate effectively, verbally and in writing; interpret and apply program policies, procedures, and regulations; establish and maintain effective working relationships with internal and external customers; work in teams and take direction from others; develop effective training materials; manage multiple tasks and meet deadlines; objectively assess a variety of program areas for quality assurance purposes; adhere to DSHS and HHS policies and procedures; function independently in the performance of professional duties.

Nice To Haves

• Experience conducting trainings and/or providing technical assistance preferred.

Responsibilities

• Conducts site visits to new THSteps medical and dental providers within 30 days of notification of enrollment.
• Outreaches existing THSteps medical and dental providers at least annually to provide technical support.
• Updates provider information in appropriate database systems within designated timeframes.
• Provides technical assistance and/or training for medical and dental providers to resolve issues and enhance their knowledge of THSteps program policy, requirements, and procedures.
• Serves as a liaison with Texas Medicaid and Health Partnership (TMHP), Medicaid Medical and Dental Managed Care Organizations in order to assist providers with billing and enrollment issues.
• Escalates complex issues to Central Office for timely resolution.
• May assist medical and dental providers to resolve patient-related issues and locate appropriate community resources.
• Promotes THSteps program at community events.
• Outreaches non-participating medical and dental providers in an effort to recruit them for participation in the THSteps program.
• Works collaboratively with relevant stakeholders to develop strategies to increase number of THSteps providers.
• Participates in regional and statewide THSteps program planning meetings.
• Inputs and/or submits reports and data within the designated timeframes.
• Responsible for documenting all activities with providers, stakeholders, and other agencies/organizations.
• Prepares and submits monthly Provider Relations Activity Report according to designated timeframes and applicable state and federal policy.
• Performs other duties as assigned.
• Duties include, but are not limited to, being required to work other than normal business hours in order to respond to public health emergencies and actively participating and/or serving in a supporting role to meet the agency’s obligations for disaster response/recovery/Continuity of Operations (COOP).
• Maintain compliance with DSHS Policy, Fleet Operations and Management & Procedures and Standards, and a current valid Texas Driver's License.

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).

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level