Residential Services Contract Monitoring

Job Description

Job Description

Role :                               Residential Services Contract Monitoring

Job Title :                       Manager, Contract Monitoring Services

Classification :             Full-time, Exempt

Reports to :                  Director, Network Contracts

Company :                     DePelchin Family Services

Location :                      Houston, TX

Position Description :

The Manager, Contract Monitoring will provide leadership and oversight to the Single Source Continuum Contractor (SSCC) subcontract monitoring for Residential Services. This position will perform highly advanced (senior-level) managerial work, complex monitoring, analysis, and oversight activities. This role will lead network monitoring initiatives and facilitate risk evaluation / monitoring processes. The Manager will also be responsible for assisting with the evaluation of new contract applicants. The position oversees teams that perform monitoring and oversight as well as the Contract Monitoring teams to ensure the efficient and effective addressing of the needs of children in care. Primary responsibilities include establishing goals and objectives, developing policies and procedures, planning, assigning, and supervising the work of staff.

Primary Responsibilities :

• Assist the Director, Network Contracts in all program development of the department, including the development of policies and procedures governing the monitoring process.
• Provide strategic leadership and oversight to the Contract Monitoring Teams. Ensure that all functions related to SSCC subcontract monitoring services are performed efficiently and effectively.
• Lead network monitoring initiatives aimed at monitoring the health of the network.
• Assist with the development, implementation, and monitoring of corrective action plans.
• Develop, collect, and evaluate data through monthly, quarterly, and annual review of deliverables.
• Review reports from regulatory entities, HHSC contractors, and other data sources.
• Develop management reports and conduct periodic written evaluations on managed care contract compliance.
• Support the identification and resolution of contract issues by collaborating with providers.
• Investigate and follow up on member or provider complaints.
• Conduct desk and on-site reviews of contracted services for network providers.
• Collaborate with program staff to identify trends and resolve technical issues.
• Develop review materials and document findings from readiness operational reviews.
• Analyze and assess documents, data, and related materials for readiness and operational reviews.
• Provide guidance in the development of managed care contracts.
• Assist with the review, analysis, and evaluation of rules, bills, and federal / state laws pertaining to SSCC programs.
• Respond to communications from internal and external stakeholders.
• Inform Director of incidents or situations that may impact staff, the department, or the agency.

Required Qualifications :

Knowledge, Skills, and Abilities :

Work Conditions :

DePelchin is Proud to be an Equal Opportunity Workplace.

DePelchin is committed to selecting and employing the best and most qualified person available for each job opening without unlawful discrimination of any kind. Additionally, DePelchin is committed to providing a work environment free of discrimination and harassment on the basis of race, color, sex (including pregnancy, sexual orientation and gender identity), marital or parental status, veteran status, religion, national origin, age, disability, family medical history, genetic information, or political affiliation.

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