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Research Specialist IV
3 weeks ago
Texas Department of Aging & Disability Services Austin, United StatesJob Description: · The Research Specialist IV reports to the Manager of the Research, Development and Methodology Team (RDM) within the Long-Term Services and Supports (LTSS) section of the Provider Finance Department (PFD) and performs complex research and rate setting work, inc ...
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Research Specialist V
3 weeks ago
Texas Department of Aging & Disability Services Austin, United StatesJob Description: · The Research Specialist V reports to the Manager of the Research, Development and Methodology (RDM) Team within the Long-Term Services and Supports (LTSS) section of the Provider Finance Department (PFD) and performs advanced (senior-level) research and rate se ...
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Research Specialist IV
1 week ago
Texas Department of Aging & Disability Services Austin, United StatesJob Description: · Under the supervision of the Environmental Epidemiology and Disease Registries Section (EEDRS) Medical Research Specialist, the Research Specialist IV performs advanced (senior-level) research work for the Texas Wastewater Epidemiology and Surveillance Program. ...
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Research Specialist V
2 weeks ago
Texas Department of Aging & Disability Services Austin, United StatesJob Description: · Research Specialist V · The Texas Health and Human Services Commission (HHSC) Medicaid and CHIP Services (MCS) department seeks a highly qualified candidate to fill the position of Research Specialist V. MCS is driven by its mission to deliver high quality, cos ...
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Research Specialist V
2 days ago
Texas Department of Aging & Disability Services Austin, United StatesJob Description: · The Research Specialist (RS) V reports to the Benefits Management Review (BMR) Manager within the Office of Data, Analytics and Performance (DAP). The position performs highly advanced (senior level) research work. The RS V analyzes Medicaid, Healthy Texas Wome ...
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Research Specialist I
3 weeks ago
Texas Department of Aging & Disability Services Austin, United StatesJob Description: · The Texas Health and Human Services (HHS) Office of Inspector General was established to combat fraud, waste, and abuse in publicly funded Health and Human Services programs. The OIG Policy and Strategic Initiatives team supports this mission by providing OIG s ...
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Research Specialist V
2 weeks ago
Texas Health & Human Services Commission Austin, United StatesThe Research Specialist V reports to the Manager of the Research, Development and Methodology (RDM) Team within the Long-Term Services and Supports (LTSS) section of the Provider Finance Department (PFD) and performs advanced (senior-level) research and rate setting work, includi ...
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Research Specialist IV
2 weeks ago
Texas Health & Human Services Commission Austin, United StatesResearch Specialist IV · Under the supervision of the Research Specialist V/Epi Team Lead, the Research Specialist IV performs highly advanced (senior-level) research work in the area of birth defects epidemiology, research, and data management. The position will coordinate branc ...
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Research Specialist V
4 weeks ago
PSG Global Solutions AUSTIN, United StatesJob/ Position Description. This position is located in the Epidemiology and Supplemental Projects Group of the TB/ HIV/ STD Epidemiology and Disease Surveillance Branch. Under the supervision of the Group Manager, the MMP Project Coordinator/ Researc Research, Specialist, Project ...
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Research Specialist IV
2 weeks ago
Texas Health & Human Services Commission Austin, United StatesThe Research Specialist IV reports to the Manager of the Research, Development and Methodology Team (RDM) within the Long-Term Services and Supports (LTSS) section of the Provider Finance Department (PFD) and performs complex research and rate setting work, including evaluation o ...
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Research Specialist III
2 weeks ago
Texas Health & Human Services Commission Austin, United StatesResearch Specialist III · The Targeted Query (TQ) Research Specialist (Research Specialist III) performs advanced queries and research related to Medicaid program data in the Office of Inspector General (OIG) Data Reviews directorate. The position reports and works under the dire ...
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Research Specialist I
4 weeks ago
Texas A & M University Kingsville Austin, United StatesJob Title · Research Specialist I · Agency · Texas A&M University - Kingsville · Department · Kleberg Wildlife Research Institute · Proposed Minimum Salary · Commensurate · Job Location · Kingsville, Texas · Job Type · Staff · Job Description · The Research Specialist I, under ge ...
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Senior Research Specialist
2 weeks ago
Texas Health & Human Services Commission Austin, United StatesThe Fraud Analytics (FA) unit within the Data Reviews Division of the Office of Inspector General (OIG) is seeking a Senior Research Specialist (Research Specialist IV) to expand the team's research capacity. The Fraud Analytics unit is responsible for performing innovative data ...
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Research Specialist I
2 weeks ago
Texas Health & Human Services Commission Austin, United StatesThe Texas Health and Human Services (HHS) Office of Inspector General was established to combat fraud, waste, and abuse in publicly funded Health and Human Services programs. The OIG Policy and Strategic Initiatives team supports this mission by providing OIG staff with policy gu ...
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The University of Texas at Austin Austin, United States Full timeJob Details · : General Notes · The at The University of Texas at Austin functions to ensure that all research conducted at the University is in compliance with applicable laws, regulations, and University policies. The ORSC educates and supports the University research commun ...
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Research Specialist II
4 weeks ago
Texas A & M University Corpus Christi Austin, United StatesJob Title · Research Specialist II · Agency · Texas A&M University - Corpus Christi · Department · Harte Research Institute · Proposed Minimum Salary · Commensurate · Job Location · Corpus Christi, Texas · Job Type · Staff · Job Description · TAMU-CC is a dynamic university desig ...
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DPS - THP - Research Specialist, MCB - 0600
2 weeks ago
State of Texas Austin, United StatesGENERAL DESCRIPTION: · Perform routine (journey-level) technical and analytical research work for Motor Carrier Bureau. Work involves collecting, processing, and disseminating information between local, state, and federal jurisdictions. Maintain the Federal Motor Carrier Safety ...
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State of Texas Austin, United StatesGENERAL DESCRIPTION: · Perform highly advanced (senior-level) technical work for the Seized Drugs (SD), Toxicology (Tox), or Biology (DNA) Programs. Work includes overseeing development, implementation, and monitoring of research projects in technical forensic programs for the D ...
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Research Specialist V
2 weeks ago
Health & Human Services Comm Austin, United StatesResearch Specialist V- The Research Specialist V reports to the Director of the Office of Quality Analytics Data and Reporting within the MCS Quality and Program Improvement Section. This office supports agency efforts to transition Medicaid to a value-based system offering bette ...
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Research Specialist Iii
2 weeks ago
Health & Human Services Comm Austin, United StatesResearch Specialist III**Essential Job Functions**: · 1. Performs advanced technical research and in-depth comparative analysis of Medicaid policies and paid claims data to identify, deter, and prevent potential fraud, waste, and abuse in the Medicaid program. (35%) · - 2. Respon ...
Senior Research Specialist - Austin, United States - Texas Department of Aging & Disability Services
Description
Job Description:
The Fraud Analytics (FA) unit within the Data Reviews Division of the Office of Inspector General (OIG) is seeking a Senior Research Specialist (Research Specialist IV) to expand the team's research capacity.
The Fraud Analytics unit is responsible for performing innovative data analytics that seek to maximize the identification of fraud, waste, and abuse (FWA) in state health and human services programs such as Medicaid (including Managed Care), CHIP, SNAP and TANF by providing data-driven insights that inform investigations, reviews, audits, and inspections.
The Research Specialist will perform research and analysis that support this effort by enhancing Fraud Analytics' ability to leverage complex healthcare data and advanced analytics to effectively identify FWA.
The FA Research Specialist oversees complex project development, conducts thorough policy and data research, and produces clear deliverables and reports.
This position reports to the Director of Fraud Analytics and works under limited supervision, with significant latitude for the use of initiative and independent judgment.
This position works closely with Fraud Analytics team members, internal OIG units, and external entities, and may provide guidance to others.
The FA Research Specialist is responsible for developing and reviewing policies and procedures used in conducting and administering research activities, establishing quality assurance procedures, conducting quality assurance reviews on research projects, and consulting and providing technical advice on research methods and techniques.
This position serves as a subject matter expert in health and human services program data and healthcare FWA schemes and scenarios.
The position prepares written project plans, including objectives, scope, and methodology; prepares presentations and research findings; and assists with validation of research outcomes through data analysis and evaluation.
Outcomes that support and/or directly inform work of FA data analysts and data scientists will advance team objectives by facilitating new FWA lead generation resulting from the augmentation of existing detection strategies and the development and deployment of novel strategies.
This position can telework % from any OIG location within Texas consistent with HHS telework policies.
Essential Job Functions:
Attends work on a regular and predictable schedule in accordance with agency leave policy and performs duties as assigned:
1.
Conducts complex and thorough policy research, data analysis, and evidence gathering activities to determine potential violations of program laws, rules, regulations, and acceptable industry practices.
Assists with gathering and interpreting relevant program laws, regulations, and requirements; agency policies, procedures, and systems; and medical coding practices.
Identifies inconsistencies and assists with obtaining expert and legal clarification. Suggests opportunities to enhance or clarify policy or procedures to improve outcomes and prevent fraud, waste, and abuse. (30%)2.
Reviews data and conducts quality assurance activities to validate observable trends, outliers, or other patterns of behavior that may represent violations of Medicaid or other state health and human services program requirements.
Analyzes complex medical and claims data to compare patterns of behavior with policy research. Proactively reviews available research, collaborates with peers, and monitors internal and external sources to identify and track current trends. (20%)3.
Effectively communicates findings and related recommendations to the FA team, other OIG units, and external entities, including:
data analysts and data scientists, OIG program area customers, the OIG executive team, and contractors/vendors. Writes methodology documents and detailed reports; prepares and delivers presentations and data visualizations. (15%)
4. Serves as a subject matter expert in health and human services program policies and data. Closely collaborates with the OIG Policy and Strategic Initiatives team to obtain policy clarifications and make policy recommendations.
Serves as a liaison to other state agencies, licensures boards, and federal agencies regarding fraud, waste and abuse in state health and human services programs.
(10%)5.
Assists with the development of new FA projects and initiatives, including the development of project plans; the creation of templates and tools to support evidentiary requirements; and the presentation of reports and findings to both internal and external stakeholders.
Conducts related training, as needed. Ensures that work performed by the FA team complies with applicable rules, laws and professional standards. Completes project deliverables in accordance with applicable timelines, metrics, quality standards, and OIG leadership expectations. (5%)6. Develops solutions to increase the efficiency and effectiveness of division activities, promote consistency, and support program integrity. Coordinates activities to foster collaboration and to improve internal and external communication, outcomes, and program integrity. (5%)
7. Responds to inquiries and ad hoc requests expediently, professionally and in accordance with defined timeframes. Effectively reports deliverables, recommendations, challenges and action items, as appropriate. (5%)
8.
Compiles and develops executive briefing documents, issue papers, reports, and memoranda for executive decision making and delivers executive level briefings as needed and appropriate, in coordination with the Director of Fraud Analytics.
(5%)9. Performs other duties necessary to achieve the mission of the Office of Inspector General. Statewide travel of about 5% may be required.
(5%)
Knowledge Skills Abilities:
1.Knowledge of principles and practices of public administration and management.
2.Knowledge of state and federal laws, regulations, and policies related to health and human services.
3.Knowledge of the OIG operating procedures as well as the OIG's enabling legislation.
4.Knowledge of Medicaid policy and billing requirements and allowable coding practices.
5.Knowledge of research principles, techniques, procedures and best practices.
6.Knowledge of analytical and statistical tools, methods, and techniques; of data models and querying relational databases; of data wrangling, mining and visualization techniques; and of record keeping, including security procedures for handling, protecting, and distributing confidential data.
7.Skill in critical thinking, analyzing problems, and devising effective solutions.8.Skill in collecting, reviewing, cleaning and analyzing large, complex datasets.
9.Skill in verbal and written communication essential to effectively interacting with OIG customers, leadership, and team members.
10.Skill in conducting quality assurance activities and identifying trends that indicate a need for policy or process improvements or additional training.
Skill in using automated systems for documentation, research, tracking and version control.11.Ability in applying Medicaid requirements to development of rules-based and data-driven strategies for discovering trends and patterns and deriving insights that facilitate FWA detection and provider investigations.
12.Ability to evaluate information, draw logical conclusions, and effectively communicate complex findings and methodologies to non-technical audiences in concise reports and presentations.
13.Ability to use facts to prepare high-quality investigative reports and factual, convincing arguments to clearly demonstrate fraud, waste, and abuse.
14.Ability to apply agency policies and guidelines and determine compliance.15.Ability to work independently, exercise independent judgment, prioritize tasks, and manage multiple projects/assignments/responsibilities in a fast-paced environment under time constraints.
16.Ability to establish and maintain effective working relationships with others.17.Ability to work in teams that may cross departments and/or agencies.
18.Ability to develop training materials and provide guidance and training to others.
Senior Research Specialist professionals in Austin
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Kathleen Bily
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