Medicaid/CHIP Research & Resolution Specialist

Texas Health and Human Services; Austin (TX); On-site; USD 45,000 - 71,000; Full time

Benefits offered by this job

100% paid employee health insurance

Defined benefit pension

Generous time off

Career advancement opportunities

Job summary

Texas Health and Human Services (HHSC) is seeking a Program Specialist III to provide oversight of Medicaid and CHIP Managed Care Organizations. The role includes analyzing complex inquiries, interpreting Medicaid/CHIP rules, and coordinating activities among clients, providers, and agencies.

The position emphasizes contract compliance, policy development, and data-driven improvements. Located in Austin, this full-time opportunity offers telework possibilities within state policies and a

Qualifications

• Graduation from an accredited four-year college or university with major course work in a field related to health and human services generally preferred.
• Experience in Medicaid, Medicaid Managed Care, CHIP and related programs is required.
• Experience with Microsoft Word, Excel, PowerPoint or similar programs is required.

Responsibilities

• Receive, analyze, and respond to inquiries and complaints pertaining to MCOs.
• Ensure contract compliance and assess MCO performance relative to dashboard or other measures.
• Review MCO materials and collaborate with Health Plan Management teams to improve processes.
• Coordinate with staff to develop reviews and analyses for special investigations and audits.

Skills

Analytical skills

Contract management

MS Word/Excel/PowerPoint

Public presentations

Education

Bachelor's degree in a related field

Tools

TIERS

HHS Enterprise Portal

TexConnect

Excel

Job description

Texas Health and Human Services (HHSC) is seeking a Program Specialist III to provide oversight of Medicaid and CHIP Managed Care Organizations. The role includes analyzing complex inquiries, interpreting Medicaid/CHIP rules, and coordinating activities among clients, providers, and agencies.

The position emphasizes contract compliance, policy development, and data-driven improvements. Located in Austin, this full-time opportunity offers telework possibilities within state policies and a