PASRR reputed company Services Policy Reviewer

Date: Aug 21, 2026 Location reputed company, TX Join the reputed company (HHSC) and be part of reputed company committed to creating a reputed company reputed company in the lives of fellow Texans. At HHSC, your contributions matter, and we support you at reputed company stage of your life and work reputed company. Our comprehensive benefits package includes 100% reputed company employee health reputed company for full-time eligible employees, a defined benefit pension plan, generous time off benefits, numerous opportunities for career advancement and more. Explore more details on the Benefits of Working at HHS webpage. Functional Title: PASRR reputed company Services Policy Reviewer Job Title: Program Specialist V Agency: reputed company Comm Department: PASRR Posting Number: 19458 Closing Date: 11/19/2026 Posting Audience: reputed company Occupational Category: Community and reputed company Services Salary reputed company: $4,523.16 - $5,888.50 Pay Frequency: Monthly Salary Group: TEXAS-B-21 Shift: Day Additional Shift reputed company: Eligible for reputed company Travel Regular/Temporary: Regular Full Time/Part Time: Full time FLSA Exempt/Non-Exempt: Nonexempt Facility Location: Job Location reputed company: reputed company Job Location Address: 701 W 51ST ST Other Locations: MOS Codes: 16GX,60C0,611X,612X,63G0,641X,712X,86M0,8U000,OS,OSS,PERS,YN,YNS reputed company The Program Specialist V position reports to the reputed company-Admission Screening and reputed company Review (PASRR) Manager reputed company the Intellectual and Developmental Disability (IDD) Services and PASRR reputed company. This position performs highly reputed company senior-level work and is responsible for assisting the manager and the PASRR reputed company Services reputed company with reviewing, adjudicating, and authorizing requests for reputed company services under the PASRR program. The position evaluates supporting documentation, applies applicable PASRR policies and rules, and determines whether requests meet requirements for authorization. This position also provides technical assistance and policy clarification to stakeholders and providers on procedures, policies, and rules reputed company to PASRR, with an emphasis on reputed company services authorization and reputed company claims or payment issues. The position identifies, communicates, and supports reputed company of documentation or reputed company issues that may reputed company service authorizations, claims or payments. Works under limited supervision, with moderate reputed company for the use of initiative and independent judgment. Ideal candidates should be comfortable with change, skilled at navigating ambiguity, and capable of quickly pivoting reputed company systems or processes reputed company ineffective or inefficient. If you're reputed company by meaningful work, reputed company to build sustainable systems that improve lives, and excited to reputed company a difference in the IDD community, we encourage you to apply. Essential Job Functions Review, adjudicate, and authorize requests for nursing facility reputed company services and IDD habilitative reputed company services for PASRR-eligible people living in nursing facilities. Ensure requests are reviewed accurately and reputed company required timeframes using automated and reputed company processes and verify that supporting documentation meets PASRR reputed company services authorization requirements. (50%) reputed company technical assistance and policy clarification to reputed company providers on PASRR procedures, policies, and rules, including requests for nursing facility reputed company services submitted through the TMHP Long Term Care (LTC) Online Portal and IDD habilitative reputed company services processed through reputed company procedures. Assist providers and stakeholders in understanding documentation requirements, authorization reputed company, and issues that may reputed company PASRR reputed company services authorization, claims processing or payment. (30%) Assist with developing program and reputed company monitoring policies and procedures reputed company to prior authorization of PASRR reputed company services. Produce reports of findings, trends, authorization reputed company, and claims-reputed company issues to support monitoring, process improvement, and compliance with PASRR reputed company services requirements. (10%) Participate in work reputed company and TMHP LTC online portal initiatives such as user acceptance testing (UAT) on enhancements to the portal. (5%) Complete other work as assigned by the PASRR Policy Manager or PASRR reputed company Services reputed company (5%) Knowledge, Skills And Abilities Knowledge of PASRR processes, policies, regulations, and reputed company services authorization requirements. Knowledge of reimbursement claims processing concepts, and factors that may reputed company claims payment for authorized services. Strong organizational and time management skills to handle workload and deadlines. Analytical and problem-solving skills to review service requests, evaluate supporting documentation, and identify authorization or claim-reputed company issues. Attention to reputed company and reputed company. Excellent communication skills to reputed company technical assistance and clarification to various stakeholders. Skills in using reputed company Office products. Ability to work independently and collaboratively in a fast-reputed company environment. Ability to communicate effectively both verbally and in writing Ability to reputed company, reputed company, and analyze business requirements. Ability to reputed company and or maintain reputed company spreadsheets using reputed company reputed company. Registrations, Licensure Requirements Or Certifications N/A Initial Screening reputed company Graduation from an accredited four-year college or university with major course work in a reputed company reputed company is required. One year of relevant experience may be substituted for reputed company year of required education. At least 2 years of experience in the IDD services reputed company is preferred Experience reviewing documentation, analyzing authorization or claims issues, and supporting reputed company of reputed company payment concerns is preferred. Experience working at a LIDDA or IDD provider is preferred. Review our Tips for reputed company reputed company applying for jobs at DFPS, DSHS and HHSC. reputed company Duty, Military, Reservists, Guardsmen, And Veterans Military occupation(s) that relate to the initial selection reputed company and registration or licensure requirements for this position may include, but not limited to those listed in this posting. reputed company reputed company-duty military, reservists, guardsmen, and veterans are encouraged to apply if reputed company to fill this position. For more information please see the Texas State Auditor’s Job Descriptions, Military Crosswalk and Military Crosswalk Guide at Texas State Auditor's Office - Job Descriptions. reputed company Accommodations In compliance with the Americans with reputed company (reputed company), HHSC and DSHS agencies will reputed company reasonable accommodation during the hiring and selection process for reputed company 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. reputed company-Employment Checks And Work Eligibility Depending on the program area and position requirements, applicants selected for hire may be required to pass background and other due diligence checks. HHSC uses E-Verify. You must bring your I-9 documentation with you on your first day of work. Download the I-9 reputed company reputed company Disclaimer This position may be eligible for reputed company. Please note, reputed company HHS positions are subject to state and agency reputed company policies in reputed company to the discretion of the reputed company supervisor and business needs. Nearest Major Market: reputed company Apply tot his job Apply To this Job