Texas Health and Human Services
DFPS Rate Setting Team Lead / Program Specialist VI
The DFPS Rate Setting Team Lead performs work for the Provider Finance Department (PFD), Long-term Services and Supports (LTSS) section in support of HHSC’s Memorandum of Understanding with the Department of Family and Protective Services (DFPS) for rate-setting activities. This position will serve as a team lead for HHSC PFD’s rates team focusing on residential child care rate setting in Texas. This position will support of DFPS’s Foster Care Modernization project by attending meetings with DFPS and external stakeholders, assisting to develop alternative rate models based on revised service descriptions provided by DFPS, and developing fiscal and cost estimates. The position provides senior level coordination and rate analysis work related to residential child care rate methodology and calculations
The DFPS Rate Setting Team Lead performs senior level coordination, research and data analysis work to determine and evaluate 24-Hour Residential Child Care (24-Hour RCC) payment rates including pro forma and cost report-based rate modeling; assists in the development and implementation of reimbursement methodologies; oversees the collection of appropriate statistical and cost data necessary to determine payment rates and fiscal estimates; analyzes cost report information and identifies needed areas of improvement; manages the development, modification and maintenance of complex computer programs, spreadsheets and large databases used in determining payment rates; provides technical assistance to contracted providers, report/survey preparers and financial examiners. Communicates results of research and analysis to internal and external audiences and represents the department on issues related to residential foster care rates and methodology. Performs other duties as assigned and required to maintain efficient program and agency operations.
Essential Job Functions:
1. PROJECT OVERSIGHT: Services a team lead on multiyear project to calculate revised payment rates for 24-Hour RCC program including legacy foster care and Community Based Care (CBC). Provides guidance to other project staff on complex, technical and analytical methods used in rate determination. Provides effective planning, organization to meet internal, legislative, State and/or Federal requirements. Ensures compliance with program policies and procedures, statutes, and rules; and takes corrective action(s) as needed. (25%)
2. DEVELOPMENT AND ANALYSIS: Oversees development, implementation and maintenance of rate methodologies and rate calculations for 24-Hour RCC rate setting and rate methodologies including Legacy foster care and CBC. Ensures rate calculations using advanced statistical techniques including pro forma modeling and calculating fiscal estimates are accurate according to program and project goals. Oversees the development, modification and maintenance of complex computer programs, spreadsheets and large databases used in 24-Hour RCC payment rate analysis. Ensures calculated rates conform to legislative direction, project or program goals and objectives, Texas Administrative Code rules, internal policies and procedures, and general accounting principles. Recommends improvements for cost reporting process, rate methodologies and rate calculations. (20%)
3. STAKEHOLDER AND STAFF COMMUNICATIONS: Interfaces with various PFD and DFPS staff, contracted vendors, provider industry representatives, legal staff, workgroups and other interested parties concerning payment rate policy issues affecting program delivery and payment rate determination. Communicates complex information to internal and external parties to provide, exchange or verify information, answer inquiries, address issues or resolve problems or complaints. (20%)
4. DOCUMENTS FOR APPROVAL AND PRESENTATION: Oversees the preparation of and review of written briefing documents and other documents including legislative reports related to the results of rate development and analysis for decision making by executive staff. Makes presentations to a variety of audiences and HHSC executive staff. Contributes to the development department policies and procedures as the subject matter expert for the team and processes policy documents (including but not limited to policy guidelines, instructional documents, briefing documents, workgroup materials, TAC amendments and hearing and other notices. (15%)
5. SURVEYS AND DATA COLLECTION: Assists in the development and/or conducting surveys or cost reports to collect cost data for use in payment analysis. Contributes to the design of cost data collection instruments and detailed instruction manuals to collect cost data for feasibility of use in payment rate analysis. Provides technical assistance related to cost survey completion, policy guidelines and rule requirements. (10%)
6. PROMOTES IMPROVEMENT AND INNOVATION: Actively contributes to the continuous improvement of department processes through ongoing initiatives including: solutions to automate; building efficiencies; and maintaining consistency across multiple 24-Hour RCC rate models and calculations, departmental processes and procedures, and by evaluating existing tools and applications used in rate setting or rate methodologies. (5%)
7. OTHER DUTIES: Performs other duties as assigned. Attends work on a regular and predictable schedule in accordance with agency leave policy and performs other work assigned or required to maintain and support the office and HHSC operations. (5%)
Knowledge Skills Abilities:
• Knowledge of health and human service and residential child care programs, services, and procedures including reimbursement principles.
• Experience in developing and implementing complex data analyses.
• Ability to interpret and/or develop and implement policies, procedures and state and federal regulations.
• Ability to use personal computers and word processing, spreadsheet, statistical and other software in developing payment rates.
• Ability to set priorities and to plan, organize and coordinate work with others.
• Ability to manage projects effectively and to produce quality work within short deadlines.
• Ability to work under limited supervision, exercise independent judgment, set priorities, meet deadlines and adapt to shifting technical and political developments.
• Ability to communicate knowledge effectively to a variety of audiences, both verbally and in writing.
• Ability to learn and teach complex, detailed concepts.
• Skill in interpersonal relationships, teamwork and establishing and maintaining effective working relationships with people at various levels of expertise.
Registration or Licensure Requirements:
Initial Selection Criteria:
Graduation from a 4-year college or university. Experience within Provider Finance may be substituted for education on a year to year basis.
At least 6 months experience in developing payment rates for Medicaid health and human services programs or child welfare programs, preferred.
Experience in Residential Child Care or child welfare programs and services and/or rate setting or financial data analysis, preferred.
Experience in designing and conducting complex data analyses, preferred.
Experience with basic accounting principles, applying accounting and/or statistics, including use of statistical applications, preferred.
Additional Information: NA
To Apply, Click the link: DFPS Rate Setting Team Lead
Posted: January 14, 2022