Director of Medicaid Systems Modernization

Texas Health & Human Services Commission•Austin, TX

1d•$8,488 - $13,000•Hybrid

About The Position

The Texas Health and Human Services Commission (HHSC) Medicaid CHIP Services (MCS) Division seeks a highly qualified and experienced candidate to fill the position of Director of Medicaid Systems Modernization. This position provides leadership and oversight of Medicaid Enterprise Systems (MES) in coordination with HHSC Information Technology (IT) and implements critical technology modernization initiatives within Texas Medicaid systems. The director serves as the business lead for Medicaid and CHIP Services for all Medicaid-related technology projects, ensuring strategic alignment with organizational priorities and the overall technology roadmap. The selected candidate will be the primary driver for change and improvements to MES modernization efforts for the Texas Medicaid program, one of the largest in the country with responsibility to deliver services to over 4 million recipients. Key responsibilities include but are not limited to: Creating a project management organization for MES Modernization that includes intake, governance, and project/program management delivery. Developing, planning, and executing current and long-range strategies to ensure MCS business processes are efficiently and effectively integrated with appropriate and innovative technology solutions. Overseeing and serving as the business lead for information technology activities in the Texas Medicaid Program, to include providing direction for IT system planning, development, and implementation. Strategic and operational oversight for large-scale systems and applications, including but not limited to Texas Medicaid fee-for-service Claims Management, Electronic Visit Verification, Pharmacy Vendor Drug Program, Programs for All-Inclusive Care for the Elderly, Contract Administration and Provider Monitoring, Intellectual and Developmental Disability Program Eligibility and Support, and Medicaid Technology Modernization. In partnership with the Deputy Executive Commissioner for MCS Operations and other members of the leadership team, the Director of Medicaid Systems Modernization will develop and drive the vision for how technology can most effectively support program priorities for the benefit of the Texans served by HHSC. This includes bridging the gap between contractors, internal leadership, HHSC IT, and other stakeholders. The Director will lead the implementation of a technology roadmap that cohesively supports the future modernization and modularization of the key systems supporting the Texas Medicaid program. The focus will be related to progressing current capabilities through innovation, while balancing cost effectiveness and investment. The director plans, assigns, and supervises the work of others while working under limited supervision with extensive latitude for use of initiative and independent judgment. Essential Job Functions (EJFs): Develops a Medicaid modernization strategy and plan for all Managed Care Services, ensuring alignment with CMS guidelines and provisions. (25%) Serves as the primary advisor by providing strategic intent and directional guidance to cross-functional teams for all Medicaid technology projects to ensure they are achieving desired business value including any interrelated technology outside of MCS. (20%) Oversees planning and implementation of technically complex projects designed to address goals and objectives related to leveraging data and IT to support Texas Medicaid programs. (20%) Manages and monitors vendor and contractor activity related to the modernization and modularization of the systems that support Texas Medicaid. (15%) Act as the business subject matter expert for all procurements related to Medicaid technology. Participate in the creation of procurement documents (RFPs, RFIs, SOWs, etc.) and QAT Framework documents, specifically focusing on Execution Capability Assessments and Technical Architecture Assessments. (10%) Plans, tracks, and coordinates budget expenditures relating to modernization activities. (5%) Participates as an evaluator and negotiator for procurements and completes other duties as assigned. (5%) Attends work on a regular and predictable schedule in accordance with agency leave policy.

Requirements

A 4-year degree from an accredited college or university.
At least 5 years in a senior leadership role (Sr. Director, VP) and responsibilities in a field related to complex operational or IT planning, implementation, and oversight within a healthcare environment.
At least 5 years of managerial and supervision responsibilities.
Experience leading and implementing multi-year large scale projects.
Strong written communication skills as demonstrated by well-written and largely error-free application materials submitted for consideration, which may include (but are not limited to) any of the following: state job application, letter of interest, or resume.
Knowledge of Medicaid and Medicaid Management Information System (MMIS) or Medicaid Enterprise Systems Modularity.
Knowledge of technology architecture, coupled with high technical acumen and knowledge of integration principles, techniques, and application.
Knowledge of project management principles.
Knowledge of key technology domains, including support, development, and delivery.
Knowledge of software development life cycle methodologies.
Knowledge of computing environments.
Knowledge of networks and servers.
Skill in procurement, contracting, contract administration, budgeting, and financial analysis.
Skill in customer service with a high degree of responsiveness.
Skill in communicating and presenting written and verbal information to senior leadership.
Skill in identifying, developing, and conveying information and ideas.
Ability to collaborate, define a clear vision, influence stakeholders, and drive new solutions.
Ability to mitigate cultural and change risks by building alignment with business leaders and incorporating inputs to solution delivery methodologies.
Ability to lead teams to deliver effective solutions involving multiple interfaces with legacy systems, business process changes, and collaborate with multiple groups contributing to projects.
Ability to serve as a key advisor and partner with agency business and technology executives around business strategy and IT solutions.
Ability to manage and direct both technical and non-technical experts.

Nice To Haves

PMP Certification preferred.
PMI-ACP, SCM or SAFe Certification or equivalent preferred.
A master’s degree or higher from an accredited college or university in public health, business administration, information systems, or public administration.
At least 10 years of senior leadership responsibilities in a field related to complex IT planning, implementation, and oversight within a healthcare environment.
At least 10 years of managerial and supervision responsibilities.

Responsibilities

Creates a project management organization for MES Modernization that includes intake, governance, and project/program management delivery.
Develops, plans, and executes current and long-range strategies to ensure MCS business processes are efficiently and effectively integrated with appropriate and innovative technology solutions.
Oversees and serves as the business lead for information technology activities in the Texas Medicaid Program, to include providing direction for IT system planning, development, and implementation.
Provides strategic and operational oversight for large-scale systems and applications, including but not limited to Texas Medicaid fee-for-service Claims Management, Electronic Visit Verification, Pharmacy Vendor Drug Program, Programs for All-Inclusive Care for the Elderly, Contract Administration and Provider Monitoring, Intellectual and Developmental Disability Program Eligibility and Support, and Medicaid Technology Modernization.
Develops and drives the vision for how technology can most effectively support program priorities for the benefit of the Texans served by HHSC, bridging the gap between contractors, internal leadership, HHSC IT, and other stakeholders.
Leads the implementation of a technology roadmap that cohesively supports the future modernization and modularization of the key systems supporting the Texas Medicaid program, focusing on progressing current capabilities through innovation while balancing cost effectiveness and investment.
Plans, assigns, and supervises the work of others.
Develops a Medicaid modernization strategy and plan for all Managed Care Services, ensuring alignment with CMS guidelines and provisions.
Serves as the primary advisor by providing strategic intent and directional guidance to cross-functional teams for all Medicaid technology projects to ensure they are achieving desired business value including any interrelated technology outside of MCS.
Oversees planning and implementation of technically complex projects designed to address goals and objectives related to leveraging data and IT to support Texas Medicaid programs.
Manages and monitors vendor and contractor activity related to the modernization and modularization of the systems that support Texas Medicaid.
Acts as the business subject matter expert for all procurements related to Medicaid technology.
Participates in the creation of procurement documents (RFPs, RFIs, SOWs, etc.) and QAT Framework documents, specifically focusing on Execution Capability Assessments and Technical Architecture Assessments.
Plans, tracks, and coordinates budget expenditures relating to modernization activities.
Participates as an evaluator and negotiator for procurements and completes other duties as assigned.