Job/Position DescriptionAre you ready to be professionally challenged? Are you looking to be part of a dynamic team of engaged and committed professionals? Then the Health and Specialty Care System (HSCS) may be just the place for you! The HSCS is comprised of nine psychiatric hospitals located throughout the state, and one youth residential psychiatric center in Waco. The HSCS is a hub of excellence for forensic mental health and complex psychiatric care, with all facilities accredited by The Joint Commission. The hospitals provide state-of-the-art treatment that is recovery-oriented and science-based. Whether in a direct-care or support role, your contribution will make a difference in the life of a Texan.The Program Specialist III position assists the Director of Quality Management in coordinating and overseeing the planning, implementation and evaluation of services and programs within the hospital to ensure quality of care and compliance with existing internal and external standards and directives. May assist in hospital performance improvement initiatives, monitoring hospital compliance with standards and in developing and monitoring plans of correction for noncompliant areas. Works under the supervision of the Director of Quality Management with latitude for initiative and independent judgment. This position will serve as the back-up for Utilization Management and, in that role, will evaluate appropriateness of admission, length of stay and continued stay of patients utilizing pre-established criteria. Acts as liaison between hospital in-patient units, reimbursement and CMS/insurance providers. Assists in the coordination of the hospital Utilization Management Program. Conducts utilization studies as needed and requested by hospital management.Essential Job Functions1. Attends work on a regular basis and may be required to work a specific shift schedule or, at times, even a rotating schedule, extended shift and/or overtime in accordance with agency leave policy and performs other duties as assigned.2. Assists the Director of Quality Management (QM) in ongoing projects including performance improvement initiatives and Joint Commission readiness.3. Prepares presentations and reports for hospital leadership and Governing Body.4. Communicates verbally and in writing to internal and external entities.5. Applies established criteria in the evaluation of appropriateness of hospital stay.6. Utilizes the Client Record System (CRS) for case reviews. Ensures quality treatment documentation is timely and falls within compliance guidelines.7. Acts as liaison between hospital in-patient units, reimbursement and CMS/insurance providers.8. Participates in the Utilization Management Committee and assists in preparing meeting agendas and minutes. Serves on additional hospital committees at the discretion of the Director of QM.9. Researches Joint Commission and Medicare (CMS) standards and state and departmental regulations.10. Other duties as assigned to include but not limited to support of disaster response.11. Other duties as assigned include but are not limited to actively participating and/or serving in a supporting role to meet the agencyand#146;s obligations for disaster response and/or recovery or Continuity of Operations (COOP) activation. Such participation may require an alternate shift pattern assignment and/or location.Registrations, Licensure Requirements or CertificationsNoneKnowledge Skills AbilitiesKnowledge of utilization management procedures. Knowledge of or https://jobshrportal.hhsc.state.tx.us/ENG/CareerPortal/job_profile.cfm?szOrderID=590113 Copy the URL in the preceding sentence to an Internet Explorer browser to apply to the job directly through the Texas Health and Human Services Career Portal.