The Quality Assurance Manager is selected by and reports to the Director of Program Support for Provider Investigations within the Health and Human Services (HHS) Regulatory Services Division, and is responsible for performing routine (journey-level) managerial work by administering the daily operations and activities to the Quality Assurance team in support of the quality assurance system. The Quality Assurance Manager is responsible for the team's development, delivery and support of quality assurance, appeals processing, and performance management.
Work involves establishing strategically-aligned team goals and objectives; developing guidelines, procedures, rules and regulations; developing schedules, priorities and standards for achieving goals; and developing and implementing techniques for evaluating activities and goal attainment. Plans, assigns, and supervises the work of others, and ensures compliance to guidelines, procedures, rules, and regulations. Works under minimal supervision, with latitude for the use of initiative and independent judgment.
Attends work on a regular and predictable schedule in accordance with agency leave policy and performs other duties as assigned. Essential Job Functions:
Performs a variety of complex managerial work overseeing the daily operations and activities of the quality assurance team. Performs high level planning, organization, monitoring, prioritization, and coordination of resources for the quality assurance team.
Oversees the timely and ongoing transmittal of completed assignments. Oversees the appeals process. Oversees case readings and other quality assurance and compliance activities.
Provides technical guidance and assistance to quality assurance specialists. Mentors, trains, and develops direct reports in the performance of their job duties. Communicates and coordinates effectively with program and state office leadership, other state agencies, external stakeholder groups, and various other organizations.
Documents and explains quality assurance review findings and recommendations. Analyzes quality assurance findings to identify trends or patterns. Develops and conducts staff training as new program policies and procedures are implemented or new programs are mandated by the federal government.
Reviews trends and resolves problems regarding the methods of quality assurance operations or procedures. Evaluates success of the current processes, best practices, and leads the implementation of changes where improvements must be made. Prepares reports and maintains records of operations.
Oversees the preparation of management and productivity reports and studies. Establishes goals and objectives; develops and approves schedules, priorities, and standards for achieving goals; and manages evaluation activities. Develops and implements techniques for evaluating business functions or division or department activities.
Plans, implements, coordinates, monitors, and evaluates policies and procedures related to quality assurance, appeals, and performance management; and monitors teams' compliance with those policies and procedures. Identifies areas of needed change and makes recommendations to improve operations. Manages the preparation, development, review, and revision of legislation.
Represents the program at meetings, hearings, trials, conferences, and seminars or on boards, panels, and committees. Performs related work as assigned.Knowledge Skills Abilities:
None.Initial Selection Criteria:
Experience with HHSC Provider Investigations in a full-time supervisory or managerial role with experience in developing, implementing and/or evaluating programs or policies. Graduation from an accredited four-year college or university. Additional Information:
This position may be located statewide.HHS agencies use E-Verify. You must bring your I-9 documentation with you on your first day of work.I-9 Form
Note: There may be no military occupation(s) that relate to the initial selection criteria and registration or licensure requirements for this position.
All active duty military, reservists, guardsmen, and veterans are encouraged to apply if qualified to fill this position. For more information see the Texas State Auditor's Military Crosswalk at http://www.hr.sao.state.tx.us/Compensation/JobDescriptions.aspx.
HHS agencies use E-Verify. You must bring your I-9 documentation with you on your first day of work.
In compliance with the Americans with Disabilities Act (ADA), HHS agencies will provide reasonable accommodation during the hiring and selection process for qualified individuals with a disability. If you need assistance completing the on-line application, contact the HHS Employee Service Center at 1-888-894-4747. If you are contacted for an interview and need accommodation to participate in the interview process, please notify the person scheduling the interview.
Texas Health & Human Services Commission