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    Provider Relations Representative - San Antonio, United States - Texas Department of Aging & Disability Services

    Texas Department of Aging & Disability Services
    Texas Department of Aging & Disability Services San Antonio, United States

    3 weeks ago

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    Description

    Job Description:

    Under the supervision of the Regional Manager and the direction of the Texas Health Steps Team Lead, the Program Specialist II is responsible for promoting the Texas Health Steps Program to providers, agencies, community-based organizations and other interested persons in the region.

    The position performs consultative and technical assistance to medical and dental providers in order to recruit and retain program providers. Develops and conducts training programs on program policies and procedures for providers as requested according to individual needs. Functions as a regional policy expert on THSteps Program for state contractors and stakeholders. Acts as a liaison between providers and related state programs (e.g. Texas Vaccines for Children, DSHS Lab). Collaborates with state contractors and other stakeholders related to the issues of the THSteps Program and Children's Medicaid.

    Educates and promotes THSteps Program to professional community groups such as schools, Head Start Program, hospitals, other state agencies and community-based organizations that serve children.

    This position functions with minimal direct supervision, having the obligation to research and answer questions from program providers about policy and procedures. Provider relations staff must conduct themselves with integrity and respect for legal constraints and confidentiality of health protected information according to HIPAA policy. Must comply with all reporting requirements and record retention policies. Addresses provider requests for assistance in a timely and professional manner. May respond to emergency preparedness to meet requirements.

    Attends work on a regular and predictable schedule in accordance with agency leave policy and performs other duties as assigned. Must be able to independently travel throughout the State of Texas and out-of-state to complete essential job functions.

    Essential Job Functions:

    • EJF I 40% - Consultation/Education
    • Technical Assistance: Acts as a liaison with agencies and internal programs to explain and provide technical assistance on agency and program statutory requirements.
    • Serves as Texas Health Steps provider relation's liaison to medical and dental providers and provider groups to monitor compliance with program policies and procedures.
    • Provides on-site technical visits to providers to answer questions, resolve billing issues and offer problem-solving assistance, with phone consultations as needed.
    • Collaborates with program stakeholders to identify THSteps provider training needs for program-specific training and individualized training sessions. May train others. Maintains and provides current resource materials for program providers.

  • EJF II 20% - Program Planning and
  • Community Relations: Markets Texas Health Steps Program to community and professional groups to coordinate, improve, and/or stimulate interest in the program through presentations and training.
  • Attends community meetings that relate to services for children.
  • Coordinates and collaborates community programs and program services with Medicaid Managed Care Organizations, Texas Medicaid and Healthcare Partnership, Department of State Health Services programs, MAXIMUS, Health and Human Services Commission and other state agencies and community groups.
  • May recommend and coordinate activities to produce a more effective program. Assists in analyzing the applications and variations of programs to develop an action plan for improving or initiating new programs. Assist with the planning for the annual TXHSteps conference and Provider Relations Outreach Meetings.
  • EJF III 20% - Provider Recruitment and
  • Enrollment Activities: Reviews and assists in evaluating information on service delivery system methods, outputs, and activities to identify gaps in resources and recommend improvements.
  • Reviews and evaluates areas where Texas Health Steps Provider recruitment is needed to identify gaps in resources with emphasis on areas that are undeserved and have low participation rates.
  • Assists with the development and implementation of Corrective Action Plans in these areas if identified and requested by Central Office. Coordinates activities to increase participation in the Texas Health Steps program.
  • Collaborates with Texas Medicaid and Healthcare Partnership, Managed Care Organizations, regional programs, agencies, and organizations to develop, evaluate and improve recruitment strategies and enrollment activities. Provides support and advocacy to enrolling providers.
  • EJF IV 10%
  • Administrative Functions: Prepares administrative reports, studies and performs specialized research projects. Maintains documentation of all provider relations activities for quarterly reporting. Prepares statistical or narrative reports as requested. Assists with quality assurance and utilization reviews as requested. Assists in the collection, organization, analysis, and/or preparation of materials in response to requests for program information and reports. Studies and analyzes operations and problems and prepares reports of findings and recommendations. Participates as a team member in reviewing program area functions and identifying areas of need to improve or initiate programs to improve service delivery. Attends program-related meetings and workshops.
  • EJF V 10% Other duties:
  • Responds to public health emergencies, including, but not limited to, disease outbreaks, biological, environmental and weather emergencies. Participates as requested in the event of a disaster response and/or recovery effort or Continuity of Operations (COOP) activation. Completes required training necessary to fulfill the duties of the role. Complies with DSHS immunization policy.
  • Maintains an acceptable driving record that meets the standards developed by the Texas Department of Public Safety (DPS) and safely operates either a state-owned, personal or rental vehicle to conduct state business.
  • Maintains a valid Class C Texas driver license or equivalent from another state. Performs other duties as assigned.

    Knowledge Skills Abilities:
    • Knowledge and experience with resources and health care programs that serve children.
    • Knowledge of computer software programs.
    • Knowledge of health care and delivery systems/issues.
    • Skills in public speaking, effective written communication and presentations and professional training methods.
    • Skill in using computer software programs in word processing, spreadsheets, databases, electronic mail, and Internet, specifically MS Word, PowerPoint, Excel, Access, and Outlook.
    • Skill in compiling monthly reports, travel reports, and time activity reports.
    • Skill in conflict resolution, mediation, and problem-solving.
    • Ability to communicate effectively and professionally with a variety of persons.
    • Ability to plan and conduct workshops, presentations, and educational events.
    • Ability to work independently with minimum supervision.
    • Ability to maintain confidentiality.
    • Ability to prioritize work and have good organizational skills.
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