Program Policy Medicaid Modernization Lead

Career Opportunities:
Program Policy Medicaid Modernization Lead (18137)

Posting 18137
-Posted
- Health & Human Services Comm

- Program Policy Spec A
- Community and Social Services
-b. $3000 - $4999 per month

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 V
• Agency: Health & Human Services Comm
• Department: Program Policy Spec A
• Posting Number: 18137
• Closing Date: 07/07/2026
• Posting Audience: Internal and External
• Occupational Category: Community and Social Services
• Salary Range: $4,523.16 - $7,253.83
• Pay Frequency: Monthly
• Salary Group: TEXAS-B-21
• Shift: Day
• Additional Shift: None
• Telework:
• Travel: Up to 5%
• Regular/Temporary: Regular
• Full Time/Part Time: Full time
• FLSA Exempt/Non-Exempt: Nonexempt
• Facility
  
  Location:
  
  
• Job Location City: AUSTIN
• Job Location Address: 701 W 51ST ST
• Other Locations: None
• 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 V 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 support Texas’ Medicaid delivery system. This position will have specialized knowledge in medical billing and coding and serve as the managed care policy liaison between Program Policy and MCS Operations, HHSC Information Technology, and technology vendors.

Additionally, this position will serve as the lead analyst on managed care policy questions and projects related to medical benefits and billing processes.

This position performs advanced consultative and technical work related to the planning, developing, implementing, and maintaining new technology contracts, and amending existing technology contracts to implement Medicaid modernization efforts. It includes a range of responsibilities:

• 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.
• Develops 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 documents and websites, and manage shared mailboxes.
• Assists in researching managed care organizations’ compliance with program policy contractual requirements.
• 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. It works under limited 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. (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 providers, and members. (25%)

Establishes, facilitates, and participates in…