Managed Care and Oversight Program Specialist IV

Career Opportunities:
Managed Care Contract and Oversight Program Specialist IV (21264)

Posting 21264
-Posted
09/10/2026

- Health & Human Services Comm

- MC Contracts and Oversight

- Community and Social Services
- Other Locations (1) - Additional Shifts available (1) -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:

Managed Care Contract and Oversight Program Specialist IV

Job Title:

Program Specialist IV
Agency:Health & Human Services Comm
Department:MC Contracts and Oversight
Posting Number:21264
Closing Date:09/24/2026
Posting Audience:Internal and External
Occupational Category:Community and Social Services
Salary Range:$4,263.16-$5,521.16
Pay Frequency: Monthly
Salary Group:TEXAS-B-20
Shift:Day
Additional Shift:Days (First)
Telework:
Travel:Up to 25%
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:Austin
MOS Codes: 16GX,60C0,611X,612X,63G0,641X,712X,86M0,8U000,OS,OSS,PERS,YN,YNS

Brief

Job Description:

The HHSC Medicaid CHIP Services (MCS) division seeks a highly qualified candidate to fill the position of Program Specialist IV. 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 ensuring that Managed Care Contracts and Oversight (MCCO) meet statutory requirements and implement audit recommendations within prescribed time frames.

The Program Specialist IV is selected by and reports to the Health Plan Manager (HPM) located in the MCCO Division of the MCS Department. This position will be assigned to a team responsible for ensuring compliance with contracts between MCOs and the agency. This position performs complex analysis and continuous monitoring of MCOs to determine the effectiveness of operations and contract compliance.

This position evaluates MCO performance and manages corrective actions. This position participates in the development and evaluation of MCCO policies as they affect the MCO contracts and makes recommendations for changes as needed.

This position works under limited direction with some latitude for the use of initiative and independent judgment and performs other duties as may be assigned or required.

Essential Job Functions:

Ensures compliance with contract standards and assesses MCO performance by reviewing MCO contract deliverables, performance measures, and MCO compliance with state and federal regulations.

On a prompt and regular basis, determines the effectiveness of MCO operational and contractual compliance by utilizing a standard set of assessment tools.

Promptly informs the HPM of significant MCO compliance and performance issues and provides recommendations for action.

Works collaboratively with other Health Plan Management staff, the MCO, and other external or internal stakeholders to ensure contractual compliance by developing, monitoring, and updating action plans.

Works promptly and collaboratively to assess remedies for noncompliance with contractual requirements.

Collaborates with HPM Research and Resolution promptly and in a timely manner on escalated MCO-related issues.

Responds to legislative, open records, and audit requests within specified time frames.

Facilitates or participates in functions related to operational on-sites, desk reviews, implementations readiness reviews, information sessions or other activities as required.

Manages or facilitates special research/issues projects as assigned within time frames.

Establishes and maintains effective working relationships and communication with Health and Human Services (HHS) staff, as well as other internal/or external stakeholders, and provides timely responses to requests and inquiries. a. Receives no more than 1-2 justified complaints per annual review period from internal or external customers regarding professional conduct, appropriate interactions with others, and/or timely responses to requests or…