Program Policy Medicaid Modernization Lead

2 days ago Be among the first 25 applicants

Date:
Jan 6, 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:

Program Policy Medicaid Modernization Lead

Job Title: Program Specialist VI

Agency: Health & Human Services Comm

Department: Program Policy Spec B

Posting Number: 11866

Closing Date: 01/20/2026

Posting Audience: Internal and External

Occupational Category: Community and Social Services

Salary Group: TEXAS-B-23

Salary Range: $5,098.66 - $8,304.83

Pay Frequency: Monthly

Shift: Day

Additional Shift: Days (First)

Telework: Telework

Travel: Up to 5%

Regular/Temporary: Regular

Full Time/Part Time: Full time

FLSA Exempt/Non-Exempt: Exempt

Job Location City: AUSTIN

Job Location Address: 701 W 51ST ST

Other Locations: Austin

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

The Program Policy team within the Medicaid and CHIP Services (MCS) Office of Policy is seeking a Program Specialist VI who will serve as the Program Policy Medicaid modernization lead. Medicaid modernization is an agency-wide project to streamline and update the highly complex network of interconnected systems that supports Texas’ Medicaid delivery system. This position will have specialized knowledge in medical billing and clinical coding and serve as the managed care policy liaison between Program Policy and MCS Operations, HHSC Information Technology, and technology vendors, and as a lead analyst on managed care policy questions and projects related to medical benefits and billing processes.

• Coordinates and collaborates with internal and external stakeholders to create and update policies, procedures, contract requirements, administrative rules, business rules, and communications to external stakeholders and contractors.
• Speak to community and professional groups to coordinate, improve, and stimulate interest in the program(s) and to secure support for program(s).
• Serves as liaison for community and professional groups to ensure stakeholder interests are represented in agency projects.
• Develop project timelines for assigned projects, monitors and reports on progress, and updates timelines as necessary.
• Coordinates and collaborates with the internal and external stakeholders to schedule standing meetings, respond to policy inquiries, draft reports, update content in public-facing documents and websites, and manage shared mailboxes.
• Assists in researching and analyzing managed care organizations’ compliance with program policy contractual requirements.
• Identify and prioritize business needs, ensuring alignment with agency goals.
• Participates in and helps to facilitate meetings with stakeholders, including managed care organizations, provider associations, people receiving services, and subject matter experts.

This position reports to a Manager for Program Policy in the Medicaid and CHIP Services Division. This position works under minimal supervision, with considerable latitude for the use of initiative and independent judgment.

Collaborates with other areas of MCS and HHSC to plan, develop, implement, monitor, interpret and evaluate Medicaid programs, policies, MCO contract requirements, business rules, administrative rules, waivers, and state plan. Evaluates MCO compliance with program policies and procedures, contract requirements, statutes, and rules and takes corrective action if needed. (25%)

Plans, monitors, and evaluates MCS implementation of state legislation, federal legislation, and federal rules. Analyzes state legislation, federal legislation, and federal rules to evaluate its impact to MCS and stakeholders, including MCOs, service…