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DEPARTMENT Medical Economics

SUPERVISOR Vice President, Division of Medical Economics

BASIC FUNCTION

Housed within the Division of Medical Economics, the Director of Medicaid Health Policy serves as TMAs primary subject-matter expert on Medicaid, CHIP, the uninsured, and related program areas that influence coverage, access to care, health care delivery, and physician payment within publicly financed health care programs.

MAJOR RESPONSIBILITIES

1. Serve as TMAs primary internal expert on Medicaid and CHIP, including policy and program structures related to managed care, waiver initiatives, payment methodologies, quality and value-based care programs, and administrative processes at the Health and Human Services Commission and the Centers for Medicare & Medicaid Services, while providing subject-matter expertise on related coverage and access issues affecting rural health, the ACA Marketplace, and uninsured or underinsured populations.
   
2. Identify, track, and submit comments on proposed state and federal legislation and regulations, and provide policy analysis and strategic guidance on complex regulatory, legislative, and operational issues impacting patient access, care delivery, and physician payment and practice operations.
   
3. Collaborate across TMA divisions including Public Affairs, the Office of the General Counsel, the Public Health Division, the Physician Payment Resource Center, and Communications to coordinate alignment of strategy, messaging, and member support related to Medicaid and public coverage programs.
   
4. Serve as primary staff liaison to the Committee on Medicaid, CHIP, and the Uninsured, providing policy analysis, subject-matter expertise, and operational support to physician leadership. Provide similar subject-matter expertise to the Council on Socioeconomics, the Committee on Primary Care, and other TMA councils and committees with related or overlapping policy issues, as needed.
   
5. Conduct research to support development of reports, regulatory analyses, legislative briefings, and subject-matter content for publications, member communications, and TMA digital platforms.
   
6. Develop and deliver physician-facing education, executive briefings, and presentations on policy, operational developments, and emerging risks or opportunities, including presentations for county medical societies and other internal or external audiences, as requested.
   
7. Perform other related duties as required.

SUPERVISORY RESPONSIBILITY

Yes.

INDEPENDENCE/SUPERVISION RECEIVED

Duties are performed independently to achieve assigned objectives; however, methods and procedures may not be specifically defined. Employee may be required to develop or research appropriate methods and procedures to be used.

GENERAL QUALIFICATION REQUIREMENTS

Knowledge and Experience:

Requires concentrated understanding of a specialized area of knowledge. Knowledge required is normally equivalent to attainment of bachelors degree in related field and 5 to 7 years work experience. Policy analysis expertise and strong interest in health care policy are essential with significant Medicaid-focused responsibility.

Skills and Abilities:

Ability to understand and follow oral and written instructions and to work effectively with TMA employees, physician members, external stakeholders, and the public. Must be well organized and able to plan and prioritize work, evaluate information, determine appropriate courses of action, and manage multiple responsibilities.

Strong oral and written communication skills are required, as is proficiency with word processing, presentation, and other relevant computer software. Provides high-level health policy analysis and research on Medicaid regulatory and policy issues to support consistency and continuity of policy across TMA divisions.

Periodic travel is required to attend TMA meetings and events, including TexMed and committee meetings, as well as external stakeholder meetings, educational presentations, and relevant state or national conferences.

The purpose of a job description is to describe the overall function and general responsibilities of a job. Job descriptions are used in hiring and training and to provide employees with a better understanding of employer expectations. Descriptions are revised as job responsibilities change.