Premium Payable System Program Specialist VII Program Enrollment & Support

Date:
Jul 28, 2026

Location:

AUSTIN, TX

Join the Texas Health and Human Services Commission (HHSC) and be part of a team committed to creating a positive impact in the lives of fellow Texans. At HHSC, your contributions matter, and we support you at each stage of your life and work journey. Our comprehensive benefits package includes 100% paid employee health insurance 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:

Premium Payable System Program Specialist VII Program Enrollment & Support

Job Title: Program Specialist VII

Agency: Health & Human Services Comm

Department: Progm Enrollment and Supp Mgmt

Posting Number: 19208

Closing Date: 08/11/2026

Posting Audience: Internal and External

Occupational Category: Healthcare Support

Salary Range: $5,797.66 - $9,508.25

Pay Frequency: Monthly

Salary Group: TEXAS-B-25

Shift: Day

Telework: Eligible for Telework

Travel: Up to 10%

Regular/Temporary: Regular

Full Time/Part Time: Full time

FLSA Exempt/Non-Exempt: Exempt

Facility

Location:

Job Location City: AUSTIN

Job Location Address: 4601 W GUADALUPE ST

Other Locations:

MOS Codes: 16GX,60C0,611X,612X,63G0,641X,712X,86M0,8U000,OS,OSS,PERS,YN,YNS

Brief Job Description

The Texas Health and Human Services Commission (HHSC) Medicaid and CHIP Services (MCS) department seeks a highly qualified candidate to fill the Program Specialist VII position in Program Enrollment and Support, Premiums Payable System, MCS is driven by its mission to deliver quality, cost effective services to Texans. This position makes a significant contribution to MCS’s mission by managing day-to-day operations and oversight of the Premiums Payable System while coordinating on related system projects and updates with stakeholders as required.

The Premium Payable System division of Program Enrollment and Support is responsible for ensuring the system is issuing appropriate dollar amounts, identifying performance trends, and evaluating improvement activities or remedies. Performs highly advanced consultative and technical assistance in the development of managed care payment methodology and performing data analysis to evaluate the performance of contracted Managed Care Organizations (MCOs) for Medicaid Managed Care and CHIP programs.

The Program Specialist VII position involves significant amount of planning, developing, coordinating, and implementing agency programs and providing consultative services and significant technical assistance to program staff, governmental agencies, community organizations, or the public. Ensures compliance with agency policies and standards, processes, and procedures. Manages cross-division collaboration to ensure horizontal and vertical communication, appropriate project prioritization, and effective resource utilization.

Serves as the subject matter expert in assigned work groups and other activities with respect to the Premiums Payable System operations. Works directly with the IT to coordinate, develop, document, and review processes and changes.

The ideal candidate possesses exceptional analytical and technical skills, including advanced proficiency in SQL, Microsoft Access Database, and Microsoft Excel. The successful candidate demonstrates the ability to independently analyze large datasets, identify trends and anomalies, develop complex queries, troubleshoot data issues, communicate technical finding to both technical and non-technical audiences. The ideal candidate thrives in an environment that emphasizes critical thinking and problem solving, teamwork to achieve goals, integrity, excellence through high professional standards and personal accountability, and curiosity to continuously grow and learn.

This position reports to the Director III of Enrollment Operations and works under limited supervision, with considerable latitude for the use of initiative and independent judgment.

Essential Job Functions

• Performs complex analysis of MCO capitation data and prepares statistical reports and findings, trends the performance data, answers inquiries and provides reports and technical recommendations to MCOs.
• Manages complex projects including audits of Premium Payment System (PPS) and manages risk group system rules to align with Managed Care Program changes.
• Analyzes the impact of state/federal laws and regulations on operational processes. Identifies the need for new requirements for programs to mitigate risk.
• Develops and maintains the necessary procedural documents to communicate the operational dependencies of the section's business functions.
• Improves management controls and operations efficiency by developing and implementing effective techniques and analysis tools including administrative reports, and specialized research projects. This function requires compiling written records.
• Provides professional communications to Medicaid and CHIP health plans, the Enrollment…