Program Specialist VII

TX-HHSC-DSHS-DFPS•Austin, TX

1d•Hybrid

About The Position

The Texas Health and Human Services Commission (HHSC) Medicaid and CHIP Services (MCS) division seeks a highly qualified candidate to fill the Program Specialist VII position within Program Enrollment and Support, Enrollment Broker Operations. MCS is driven by its mission to deliver quality, cost‑effective services to Texans. This position performs highly advanced (senior‑level) consultative, analytical, and project coordination work supporting the implementation of state and federal initiatives, such as the Medicaid and CHIP Quality Rating System (MAC QRS), a Centers for Medicare & Medicaid Services (CMS) initiative requiring states to develop an interactive public reporting system that allows Medicaid recipients to compare and find information about Medicaid managed care plans. Information such as provider networks, value added services, and managed care organization (MCO) performance metrics across healthcare quality domains will be available on this website in an interactive format. The Program Specialist VII serves as the Medicaid and CHIP Services project lead for assigned initiatives and provides strategic coordination across HHSC divisions and external partners. This position provides division‑level oversight and coordination to ensure project alignment, progress, and compliance with federal requirements. The role requires strong project management practices combined with the policy, analytical, and program management responsibilities typical of a senior Program Specialist. Responsibilities include coordinating stakeholders, developing and maintaining project tracking materials, monitoring deliverables and timelines, preparing executive briefings, and supporting policy and operational alignment across the Medicaid and CHIP programs. The position works under minimal supervision with extensive latitude for initiative and independent judgment. The ideal candidate demonstrates strong critical thinking, organization, and collaboration skills and thrives in a fast‑paced environment that requires strategic coordination across multiple program areas and stakeholders.

Requirements

Knowledge of Medicaid and CHIP managed care programs, enrollment policies, and related operational processes.
Knowledge of federal and state laws, regulations, and policies affecting Medicaid programs.
Knowledge of program management and public administration principles.
Knowledge of project management methodologies and tools used to track project milestones and deliverables.
Skill in coordinating complex projects involving multiple stakeholders.
Skill in preparing reports, presentations, and executive briefings.
Skill in analyzing data, policies, and operational processes to support decision‑making.
Ability to manage multiple priorities and facilitate collaboration across organizational boundaries.
Ability to identify risks and develop strategies to address operational challenges.
Ability to communicate effectively with diverse audiences including leadership, technical staff, and external partners.
At least two years of experience in Medicaid or CHIP systems‑related project management or program implementation.
Bachelor’s degree from an accredited college or university. Educational requirements may be substituted with relevant work experience on a year‑for‑year basis.

Nice To Haves

Five years of experience in Medicaid or CHIP systems‑related project management or program implementation.

Responsibilities

Leads and oversees division initiatives such as MAC QRS activities. Ensures initiatives implementation plans aligns with Centers for Medicare & Medicaid Services (CMS) requirements, agency priorities, and program operations.
Serves as the division’s lead coordinator for MAC QRS project activities across multiple program areas and enterprise partners. Works closely with project managers in Information Technology, Texas Medicaid & Healthcare Partnership (TMHP), the Enrollment Broker vendor, Managed Care Organizations, and other HHSC divisions to coordinate project activities, timelines, and deliverables.
Develops and maintains project management documentation and tracking tools including project timelines, milestones, deliverables, issue logs, risk registers, and status reports. Utilizes project management methodologies and tools to monitor project progress and ensure accountability for deliverables.
Prepares and presents executive‑level reports, briefings, and status updates to division leadership, agency leadership, and other stakeholders. Develops presentation materials and executive summaries to communicate project progress, risks, and recommended actions.
Facilitates stakeholder engagement and collaboration across internal HHSC divisions and external partners to support project implementation. Coordinates meetings, workgroups, and communications to ensure alignment and shared understanding of project requirements and objectives.
Identifies project risks, barriers, and operational challenges and works collaboratively with stakeholders to develop mitigation strategies and solutions. Escalates significant issues to leadership when appropriate and provides recommendations to support informed decision‑making.
Performs highly advanced consultative and analytical work related to Medicaid and CHIP managed care programs. Reviews and interprets federal regulations, CMS guidance, and state policy to ensure projects align with program requirements and operational processes.
Assists in the development, review, and implementation of policies, procedures, guidance documents, and operational protocols related to MAC QRS and Medicaid and CHIP managed care enrollment processes.
Monitors program activities related to MAC QRS and enrollment operations to ensure compliance with applicable federal and state regulations, policies, and contractual requirements. Identifies opportunities for program improvement and operational efficiencies.
Provides technical assistance and guidance to internal staff and stakeholders regarding project implementation, project tracking tools, and related program activities. May assist in orienting staff to project goals, roles, and responsibilities.
Leads or participates in special projects, strategic initiatives, and cross‑division efforts supporting Medicaid and CHIP Services priorities. Represents the division in internal and external work groups or committees as assigned.
Performs other duties as assigned.