The Deputy Chief Medical Director for the Medicaid and CHIP Services (MCS) division serves as a key clinical leader in the Office of the Medical Director (OMD). MCS is driven by its mission to deliver quality, cost-effective services to Texans. Among other functions, OMD provides clinical consultation and guidance to other areas within MCS, throughout the Agency, and to external stakeholder organizations. It works to provide a clinical vision for improving the health of Texans by aligning MCS programs with state public and population health priorities.
In addition to providing clinical consultation and guidance, this role also leads the Waiver Eligibility Team. The Waiver Eligibility Team conducts medical necessity determinations for children and youth served by the Medically Dependent Children Program (MDCP). The work involved is highly advanced (senior-level) clinical and administrative work to include rendering medical necessity determinations, leading a team of clinical staff, and integrating knowledge of the Medicaid and CHIP programs with up-to-date healthcare practices and evidence-based clinical guidelines. Duties may include directing training and the provision of technical assistance to HHSC staff as well as providing clinical guidance and interpretation of HHSC policy. The position interfaces with a variety of stakeholders to include providers, advocates, vendors advisory committees, legislators, Medicaid managed care organizations, and other state agencies (e.g. Department of State Health Services).
Reporting to the Chief Medical Director of MCS, this position works under minimal supervision with extensive latitude for the use of initiative and independent judgment. The Deputy Chief Medical Director serves as Acting Chief Medical Director for MCS when the Chief Medical Director is on leave or otherwise unavailable.
The ideal candidate thrives in an environment that emphasizes teamwork to achieve goals, excellence through high professional standards and personal accountability, curiosity to continuously grow and learn, critical thinking for effective execution, and integrity to do things right even when what is right is not easy.
Candidate must be in the Austin area. This is a hybrid telework eligible position that will initially require at least two in-office workdays per week and may later allow for more work from home days. Candidate must be willing to travel to State Office (North Austin Complex,4601 W Guadalupe St, Austin, TX 78751) based on business needs even if not on a scheduled in-office workday.
Essential Job Functions:
Leads the Waiver Eligibility Team - Performs and supervises the review of assessments and associated documentation for determination of waiver eligibility, interprets complex state and federal laws, regulations, and rules related to the program, guides staff in the interpretation of medical policy, provides day to day clinical guidance, support and leadership for review activities and decisions, advises nurses and leaders in the clinical decision-making activities. (40%)
Represents unit at fair hearings and administrative reviews regarding medical necessity determinations - Reviews documentation generated internally and submitted from external sources as part of the proceedings. (20%)
Directs the provision of clinical consultation to Medicaid and CHIP, other HHSC areas and sister agencies on policies and program development - Advises on policy and clinical oversight for Medicaid and CHIP program recipients to include high needs individuals and those receiving long term supports and services, monitors trends and makes recommendations for process improvement in systems. (20%)
Serves in a clinical leadership capacity in a variety of situations for MCS - Including but not limited to interfacing with the medical directors of contractors, other state agencies, healthcare associations, and organizations representing clients, providing clinical support to the legislative process to include bill analysis and resource witness testimony. Serves as Acting Chief Medical Director for MCS when the Chief Medical Director is on leave or otherwise unavailable. (15%)
Performs other duties as assigned. (5%)
Knowledge Skills Abilities:
Knowledge of medical methods, procedures, and trends of the principles and practices in the development.
Knowledge in implementation and documentation of individualized care and treatment plans.
Knowledge of disease management and risk analysis.
Knowledge of the Medicaid Program and Children's Health Insurance Program to include Medicaid waiver programs.
Knowledge of and expertise in the clinical practice guidelines development process.
Knowledgeable of the principles of leadership and how to effectively interact with various leadership styles.
Ability to plan, assign, and evaluate the work of others.
Ability to work collaboratively and build strong relationships with key staff and stakeholders.
Ability to interact effectively and professionally with persons from diverse cultural, socioeconomic, educational, racial, ethnic, and professional backgrounds.
Ability to understand and effectively interpret agency and program rules, policies, and procedures.
Ability to perform policy and medical research to include critical appraisal of scientific literature.
Ability to communicate effectively orally and in writing.
Ability to work independently with minimal supervision.
Skill in the care of and treatment of patients to include use of diagnostic and treatment tools and equipment.
Skill in problem identification, analysis, and resolution.
Skill in the use of computer software, specifically Windows, Microsoft Outlook, Word, Excel, and Power Point.
Registration or Licensure Requirements:
Candidate must be licensed as a Medical Doctor by the state of Texas and be in good standing.
Candidate must be board certified in Family Medicine, Internal Medicine, Internal Medicine-Pediatrics, or another adult-serving specialty/subspecialty as recognized by the American Board of Medical Specialties.
Initial Selection Criteria:
Medical degree from a U.S. accredited medical college or university (either allopathic or osteopathic) or a foreign medical degree determined to be equivalent by an acceptable education evaluator.
Completion of a residency program accredited by the Accreditation Council for Graduate Medical Education.
At least five years of experience as a practicing physician in a predominantly clinical setting (not including residency training).
At least two years of experience in a clinical or administrative leadership role.
Clinical experience caring for individuals enrolled in Medicaid and/or CHIP.
Additional Information:
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.
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: Staff Corps, Medical Corps, 42, 44, 45, 48, 60, 61, 62, 67. 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.
