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Director, CAPM Operations

Company: North Texas State Hospital - Wichita Falls Campus
Location: Wichita Falls
Posted on: June 12, 2021

Job Description:

Contract Administration Mgr II performs highly advanced (senior-level) operational oversight; providing direction and guidance for contract reporting, compliance and operational administration related to the Contract Administration and Provider Monitoring Office (CAPM) within the Medicaid and CHIP Services Department (MCS). The Contract Administration Manager II leads a staff that performs financial and contract oversight and coordinates with other areas of the agency to ensure contract compliance. Develops and implements resources and tools for CAPM staff for monitoring contract compliance and performance. Performs senior -level policy analysis, research and project management to continually develop the knowledge, skills, tools and resources necessary to ensure that CAPMs focus, policies, work methods and practices align with state and federal policies, practices. Assists in the development of new strategies and policies that lead to improved results. Performs senior level research; interprets and analyzes federal and state statutes, rules, regulations, guidance, contracts and procedures includes achieving the goals and objectives as set by the Director; developing and reviewing policies, procedures and guidelines, establishing priorities, standards, and metrics to ensure outcomes which can be evaluated and measured. Provides technical expertise and coordinates with other areas within the agency, as well as federal, state, and local officials. Works under minimal supervision with considerable latitude for the use of initiative, independent judgement, and decision-making.

Essential Job Functions:
30% Oversees a team of subject matter experts, administrative and special projects staff responsible for the day-to-day shared service operations related to policy, administration, complaints and appeals; data quality assurance and reporting; in the development, implementation, and maintenance of documented and reportable controls, and best practice processes. Ensures transparency, accountability, and responsibility of measurable performance results; and the continuous improvement in support of the CAPM contract management and compliance functions. Performs compliance reviews and other quality assurance controls to identify performance trends, recommending appropriate actions based on analysis, and clearly articulating them verbally and in writing. Confirms appropriate intervention and remedies are coordinated and implemented in accordance with applicable state and federal requirements.

20%Plans, assigns, and supervises the work of others; promotes ethical leadership, excellent performance, confidentiality, a positive working environment, and professional development; and uses leadership and teambuilding skills to motivate department staff to work toward common objectives and goals. Develops and maintains relationships across internal and external stakeholders to ensure program, project and contract activities are collaborative and coordinated with impacted parties. Collaborates with agency staff and leaders to identify and drive implementation of best practices and programs; shares relevant information; identifies concerns and trends; and recommends improvements to resolve problems or enhance operations in the management and implementation of daily activities to effectively accomplish goals. May represent the program at business meetings, conferences, and seminars or on boards, panels, and committees.

20% Develops and implements tools to analyze contractor performance using information that includes but is not limited to: expenditure data, performance reports, quality management reports, technical assistance and training documentation, and other pertinent data as it relates to contractor performance. Communicates the results and recommends actions on a routine basis to program and other CAPM or HHSC staff as appropriate.

15% Reviews and approves management, productivity and financial reports and studies. Reviews guidelines, procedures, rules, and regulations, and monitors compliance. Develops program goals and objectives to align with CAPM and HHSC strategic and business plans. Ensures implementation of agency priorities, business plan measures, and related initiatives. Plans, develops, implements, coordinates, monitors, and evaluates policies and procedures.

10% Directs program area(s) and activities. Develops and implements techniques for evaluating program activities. Reviews results of special investigations, internal audits, sunset committee recommendations, SAO recommendations, research studies, forecasts, and modeling exercises to provide direction and guidance. Ensures that audit recommendations are operationalized.

10% Develops training materials and delivers presentations to management and staff related to procurement and contracting requirements and other program information. Serves as subject matter expert on assigned workgroups.

Other duties as assigned. May be required to work hours outside of normal business hours as needed.

Knowledge Skills Abilities:
Knowledge of federal and state Medicaid and CHIP laws, regulations as well as federal laws and legislation preferred. Proven skills in analyzing and evaluating complex federal and state legislation, program, policy, and operations issues. Advanced project management skills and ability to establish project goals and objectives. Experience in implementation of complex Medicaid and CHIP initiatives preferred. Proven ability to manage advanced complex initiatives with independent judgment including addressing changes in project scope, resources, and budget. Knowledge of policies and operating systems in fee-for-service and managed care preferred. Ability to analyze complex information and develop options and plans to address identified issues. Skill in performing complex, advanced level research. Skill in synthesizing, analyzing and evaluating highly complicated and technical information and translate it into easily understandable and concise documents and oral presentations for agency execution, elected officials and the public. Skill in identification of project risks and gaps and the ability to develop creative and workable solutions to complex problems and policy issues. Skill in interpersonal relationships, including the ability to work with people under pressure, negotiate among multiple parties, resolve conflicts, and establish and maintain effective working relationships with various level personnel in governmental entities. Proven negotiation and facilitation skills. Proven ability to apply independent judgment in making critical decisions. Ability to lead and work cooperatively in a team environment. Ability to use word-processing and spreadsheet applications in a windows environment. Skill in communicating effectively both orally and in writing.

Registration or Licensure Requirements:
Certified Texas Contract Manager (CTCM) is preferred and required within 12 months of hire date unless otherwise approved by supervisor.

Initial Selection Criteria:
Minimum five years of experience in contract management. Minimum of five years of experience in business process improvement initiatives, including development of policies/procedures. Supervisory experience preferred.

Additional Information:
Req 485419

MOS Code:
Military occupation(s) that relate to the initial selection criteria and registration or licensure requirements for this position may include, but not limited to: 51C, LS, SK, 3044, 6C0X1. 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 Auditors 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.

- Click here to download the I-9 form.

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.

Keywords: North Texas State Hospital - Wichita Falls Campus, Wichita Falls , Director, CAPM Operations, Other , Wichita Falls, Texas

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