Senior PASRR Policy & Services Specialist (Telework)

FALL CREEK FARM & NURSERY; Austin (TX); On-site; USD 50,000 - 66,000; Full time

Benefits offered by this job

Telework eligibility

Paid health insurance

Career advancement opportunities

Job summary

The Program Specialist V position at the Health & Human Services Commission in Austin, TX leads complex reviews of PASRR requests for specialized services in nursing facilities. It involves adjudication, authorization, and policy guidance to providers, with emphasis on documentation and timely processing.

Ideal candidates bring PASRR knowledge, strong organizational skills, and the ability to navigate changing processes.

Qualifications

• Graduation from an accredited four-year college or university with major course work in a human services field is required.
• One year of relevant experience may be substituted for each year of required education.
• At least 2 years of experience in the IDD services field is preferred.
• Experience reviewing documentation, analyzing authorization or claims issues, and supporting resolution of complex payment concerns is preferred.

Responsibilities

• Review, adjudicate, and authorize requests for nursing facility specialized services and IDD habilitative specialized services for PASRR-eligible people living in nursing facilities.
• Ensure requests are reviewed accurately and within required timeframes using automated and manual processes and verify that supporting documentation meets PASRR specialized services authorization requirements.
• Provide technical assistance and policy clarification to external providers on PASRR procedures, policies, and rules.
• Produce reports of findings, trends, authorization outcomes, and claims-related issues to support monitoring, process improvement, and compliance with PASRR specialized services requirements.
• Participate in work groups and TMHP LTC online portal initiatives such as user acceptance testing (UAT) on enhancements to the portal.
• Complete other work as assigned by the PASRR Policy Manager or PASRR Specialized Services Lead

Skills

PASRR knowledge

Policy clarification

Documentation review

Claims analysis

Communication

Excel

Microsoft Office

Education

Bachelor's degree in human services

Tools

TMHP LTC Online Portal

Job description

The Program Specialist V position at the Health & Human Services Commission in Austin, TX leads complex reviews of PASRR requests for specialized services in nursing facilities. It involves adjudication, authorization, and policy guidance to providers, with emphasis on documentation and timely processing.

Ideal candidates bring PASRR knowledge, strong organizational skills, and the ability to navigate changing processes.