Job Description:

Program Specialist VI
This position performs highly advanced (senior-level) consultative services and technical assistance work for the Cross Coordination &
Pharmacy Benefit Oversight team. This position is responsible for ensuring contract requirements are met, identifying performance trends, and evaluating improvement activities or contract remedies. This position trains, leads, assigns, and prioritizes staff assignments including development, implementation, and management of complex performance management plans for the various pharmacy benefit contracts administered by Texas Health & Human Services. This position participates in and or oversees the development of policies, guidelines, procedures, and communication produced by the unit. Participates and or Oversees compliance and project coordination with the Health and Human Services (HHS) enterprise programs and stakeholders. Develops improvement plans with stakeholders and contractors for identified deficiencies. Oversees compliance with agency policy and unit standards,
processes, and procedures. Provides cross-division collaboration to ensure horizontal and vertical communication, appropriate project
prioritization, and effective resource utilization.

 

Essential Job Functions:

Attends work on a regular and predictable schedule in accordance with agency leave policy and performs other duties as assigned.
(15%)Participates in the development of plans and actions to meet the goals and objectives of the program including but not limited to:
The development and implementation of the program's policies, procedures, rules and guidelines affecting the overall functioning of the program; the implementation of policies, procedures, rules and guidelines deemed appropriate for the administration of the program;
the development and use of evaluation tools designed by program staff to determine/measure the progress towards meeting the goals and objectives of the program; Participates in all evaluation activities of the program (internal, external and contractor evaluation); provides updates to leadership.
(15%) Participates in and oversees compliance and project coordination with the Health and Human Services (HHS) enterprise programs and stakeholders. Consults with private and public agencies to resolve problems, identify training needs, and discuss program effectiveness. Performs other duties as assigned.
(10%)Participates in the development and implementation of program processes and tools for use by staff to determine if contractors are meeting their contract performance obligations and directing staff toward identifying trends or anomalies that may require additional oversight and monitoring. Participates in and or oversees on-site and desk reviews of pharmacy benefit contractors.
(20%) Provides consultative services and technical assistance to the division and department staff related to performance management and monitoring. Oversee others who represent the Vendor Drug Program including contracted vendors at meetings, hearings, trials, conferences and seminars.
(15%) Participates in and or oversees the development and implementation of strategic goals by gathering pertinent business, financial, service, and operations information; identifying and evaluating trends and options; choosing a course of action; defining objectives; and evaluating outcomes for the program. Oversees compliance with the risk and issue management program to ensure critical risks and issues are mitigated and elevated.
(10%) Participates in and or oversees the development of the program's goals and objectives to support the development of strategic plans and program priorities, including but not limited to: may oversee special studies and/or analysis to identify methods/processes/procedures that have a positive and negative effect on the program in order to determine areas of the program that require change to ensure the overall efficient functioning of the program; participates in and or oversees the development and implementation of effective techniques for evaluating policies, process and procedures and devising solutions to achieve program improvement.
(15%) May participate in and or oversees the development of program communications and reports to external and internal parties regarding performance management issues, activities or results. May participate in and or oversee others who prepare status reports for management identifying progress, productivity, key milestones, results of evaluation activities, overall performance of contractor, trends or anomalies that may require additional contract oversight and action.
 

Registrations, Licensure Requirements or Certifications:

Certified Texas Contract Manager (CTCM) preferred, or the ability to obtain certification within 12 months of hire date and to maintain certification throughout employment.
 

Knowledge Skills Abilities:

Knowledge of state and federal laws and regulations relevant to the Medicaid/CHIP programs. Knowledge of contracting regulations, negotiating contracts, developing contracts, monitoring contracts. Knowledge of contract processes. Skills in operating personal computers and in using applicable software, including Microsoft products, i.e. MS Word, Excel. Ability to evaluate contracts and recommend future actions. Ability to interpret policies, procedures, and regulations. Ability to evaluate
fiscal data for reasonableness, necessity and conformity with contract requirements. Strong ability to write and edit correspondence, memoranda, contract requirements and specifications. Ability to negotiate features of a contract. Ability to monitor and evaluate contractor performance. Strong ability to communicate effectively; to monitor and evaluate contractor performance. Ability to communicate effectively both orally and in writing. Ability to lead or facility workgroups. Ability to communicate with internal and external stakeholders.
 

Initial Screening Criteria:

Three years of experience in procurement, contract data reporting, or contract monitoring work/responsibilities. Demonstrated knowledge and experience in the development, implementation, evaluation and interpretation of program policies and at least two (2) or more of the following areas: outpatient pharmacy, Medicaid and CHIP, state and federal legislation, managed care programs, and/or contract management. Graduation from an accredited four-year college or university preferred. Experience and education may be substituted for one another. Certified Texas Contract Manager (CTCM) and advanced Excel and SharePoint skills are preferred.