HCS/TxHmL Advisor

Texas Health & Human Services Commission; Oregon; Hybrid; USD 45,000 - 58,000; Full time

Benefits offered by this job

Paid health insurance

Pension plan

Generous time off

Career advancement opportunities

Job summary

Texas Health and Human Services Commission (HHSC) Medicaid and CHIP Services (MCS) seeks a Program Specialist III to support the IDD Program Eligibility and Support (IDD PES) unit. You will help ensure eligible Texans are enrolled in HCS, TxHmL, CLASS, ICF/IID, and CFC NW programs, handling enrollments, transfers, and terminations.

You will coordinate with local IDD authorities, monitor LOC/LON determinations, and prepare materials for hearings.

Qualifications

• Experience with Medicaid programs (HCS, TxHmL, ICF/IID).
• Familiarity with LTCOP/TIERS systems preferred.
• Strong organization and prioritization skills.

Responsibilities

• Review and process enrollments, transfers, terminations, and suspensions for HCS and TxHmL.
• Provide moderately complex consultative and technical assistance to management, HHSC staff, LIDDA staff, providers, and participants.
• Develop recurring reports and conduct data analysis to support program objectives.
• Prepare presentation materials and communicate program rules to stakeholders.
• Serve as agency representative in fair hearings.

Skills

Medicaid knowledge

Program eligibility

Data analysis

Microsoft Office

Communication

Records management

Tools

Microsoft Office

Job description

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: HCS/TxHmL AdvisorJob Title: Program Specialist IIIAgency: Health & Human Services CommDepartment: IDD Prog Eligibility and SpprtPosting Number: 22498Closing Date: 11/04/2026Posting Audience: Internal and ExternalOccupational Category: Community and Social ServicesSalary Range: $4,020.33- $5,178.00Pay Frequency: MonthlySalary Group: TEXAS-B-19Shift: DayAdditional Shift: Days (First)Telework:Travel: Up to 5%Regular/Temporary: RegularFull Time/Part Time: Full timeFLSA Exempt/Non-Exempt: NonexemptFacility Location:Job Location City: AUSTINJob Location Address: 701 W 51ST STOther Locations:MOS Codes: 16GX,60C0,611X,612X,63G0,641X,712X,86M0,8U000,OS,OSS,PERS,YN,YNS

Medicaid and CHIP Services (MCS) at the Texas Health and Human Services Commission (HHSC) seeks a highly qualified candidate to fill the position of Program Specialist III. 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 providing moderately complex consultative and technical assistance for the Intellectual and Developmental Disabilities Program Eligibility and Support (IDD PES) unit. The Program Specialist III reports to the Unit Manager within IDD PES. The IDD PES team is responsible for ensuring eligible Texans are enrolled in programs serving individuals with intellectual and/or developmental disabilities. These programs include Home and Community-based Services (HCS), Texas Home Living (TxHmL), Community Living Assistance and Support Services (CLASS), the Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Condition (ICF/IID), and Community First Choice Non-Waiver (CFC NW). IDD PES staff authorize and verify programmatic eligibility for the listed programs. In addition, IDD PES staff process enrollments, transfers, suspensions, and terminations for HCS, TxHmL, and CLASS and coordinate and attend Fair Hearings. Work involves the review and processing of enrollments, transfers, terminations, and suspensions for the HCS and TxHmL programs. Work also involves monitoring enrollment activities, such as Individual Plans of Care (IPC) and Level of Care/Level of Need (LOC/LON) determinations. This position coordinates with the local IDD authorities (LIDDAs) to monitor individuals whose services have been suspended and serves as a liaison with Medicaid for the Elderly and Persons with Disabilities (MEPD) to verify financial eligibility (Medicaid) for the program. Work also involves monitoring provider and LIDDA inquiries and ensures timely resolutions. Conducts analysis of data and reports as assigned, and collects, organizes, analyzes and prepares materials in response to requests for program information or fair hearings. Assists in creating presentation material, organizing documents and may present program rules, policy and procedure information to internal and/or external stakeholders. Works under general supervision with moderate latitude for the use of initiative and independent judgment.

The ideal candidate thrives in an environment that emphasizes teamwork to achieve goals, excellence through high professional standards and personal accountability, curiosity to continuously grow and learn, critical thinking for effective execution, and integrity to do things right even when what is right is not easy.

Essential Job Functions

• Attends work on a regular and predictable schedule in accordance with agency leave policy and performs other duties as assigned.
• (35%) Reviews and processes enrollments, transfers, terminations, and suspensions for the HCS and TxHmL programs using various electronic database systems.
• (25%) Provides moderately complex consultative and technical assistance, including research, assessment and planning directly to management, HHSC staff, LIDDA staff, program providers, program participants and their families.
• (15%) Monitor provider and LIDDA inquires by managing multiple spreadsheets and navigating various electronic database systems.
• (10%) Develops recurring reports and conducts data analysis in accordance with program objectives and goals.
• (10%) Assists in creating presentation material, organizing documents and may present program rules, policy and procedure information to internal and/or external stakeholders.
• (5%) Serves as agency representative in fair hearings.

Registrations, Licensure Requirements or Certifications: None

Knowledge Skills Abilities

• * Knowledge of Medicaid wavier programs (such as HCS, TxHmL, or ICF/IID)
• * Knowledge of federal and state laws relating to long term care and/or other Medicaid and non-Medicaid services and programs
• * Knowledge of program planning, evaluation, and implementation
• * Skilled in organization and prioritization
• * Ability to communicate effectively, both orally and in writing
• * Ability to understand and follow policies and procedures
• * Ability to maintain accurate files, records, and databases
• * Ability to gather, assemble, correlate, and analyze information
• * Ability to operate computers and experience using Microsoft Office products

Initial Screening Criteria

• * Work experience within a Medicaid program (such as HCS, TxHmL, or ICF/IID)
• * Experience working with the Long Term Care Online Portal (LTCOP) and/or Texas Integrated Eligibility Redesign (TIERS) systems preferred.
• * Experience using Microsoft Office products.

Active Duty, Military, Reservists, Guardsmen, and Veterans :Military occupation(s) that relate to the initial selection criteria and registration or licensure requirements for this position may include, but not limited to those listed in this posting. All active-duty military, reservists, guardsmen, and veterans are encouraged to apply if qualified to fill this position. For more information please see the Texas State Auditor's Job Descriptions, Military Crosswalk and Military Crosswalk Guide at Texas State Auditor's Office - Job Descriptions.

ADA Accommodations:In compliance with the Americans with Disabilities Act (ADA), HHSC and DSHS agencies will provide reasonable accommodation during the hiring and selection process for qualified individuals with a disability. If you need assistance completing the on-line application, contact the HHS Employee Service Center at . If you are contacted for an interview and need accommodation to participate in the interview process, please notify the person scheduling the interview. Pre-Employment Checks and Work Eligibility:Depending on the program area and position requirements, applicants selected for hire may be required to pass background and other due diligence checks. HHSC uses E-Verify. You must bring your I-9 documentation with you on your first day of work. Download the I-9 FormTelework Disclaimer:This position may be eligible for telework. Please note, all HHS positions are subject to state and agency telework policies in addition to the discretion of the direct supervisor and business needs.