Operations and Readiness Review Specialist

Texas Health and Human Services; Austin (TX); On-site; USD 54,000 - 70,000; Full time

Benefits offered by this job

100% paid employee health insurance

Defined benefit pension

Generous time off

Job summary

Texas Health and Human Services Commission (HHSC) Medicaid CHIP Services seeks an Operational and Readiness Review Specialist. You will ensure MCOs meet contractual and regulatory standards, lead readiness and operational reviews, and collaborate with internal and external stakeholders to advance program integrity and results.

The role requires travel for regular operational reviews and contributes to policy implementation, with a focus on accountability and high professional standards.

Qualifications

• Minimum of 120 semester hours and a four-year college degree in a healthcare-related field preferred.
• Experience with Medicaid/CHIP managed care programs and contract management is expected.
• Strong analytical, investigative and reporting abilities are required.

Responsibilities

• Ensure contract standards and MCO performance comply with state and federal regulations.
• Assess operational and contractual compliance using standard tools and metrics.
• Inform management of significant compliance issues and provide action recommendations.
• Collaborate with MCCO staff, MCOs, and stakeholders to implement action plans.
• Lead on-site reviews, desk reviews, and readiness activities as needed.
• Develop reports and materials from readiness reviews and maintain stakeholder communications.

Skills

Contract management

Compliance

Analytical skills

Research & audits

MS Office

Written & oral communication

Public presentations

Policy evaluation

Team collaboration

Education

Bachelor's degree in a related field

Tools

Microsoft Office

Job description

Date: Nov 12, 2026

Location: AUSTIN, TX

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: Operations and Readiness Review Specialist

Job Title: Contract Specialist IV

Agency: Health & Human Services Comm

Department: MC Contracts and Oversight

Posting Number: 23248

Closing Date: 11/26/2026

Posting Audience: Internal and External

Occupational Category: Community and Social Services

Salary Range: $4,801.16 - $6,281.33

Pay Frequency: Monthly

Salary Group: TEXAS-B-22

Shift: Day

Telework:

Travel: Up to 20%

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: 3006,3044,8640,310X,36A,36B,51C,60C0,62S0,63G0,63S0,64PX,651X,6C0X1,751X,FIN10,F&S,LS,LSS,SEI16,SK

Brief Job Description

The Texas Health and Human Services Commission (HHSC) Medicaid CHIP Services (MCS) department seeks a highly qualified candidate to fill the position of Operational and Readiness Review Specialist. 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 Managed Care Organization’s (MCOs) meet contract, state, and federal regulations through Operational and Readiness reviews. This position requires the necessity to travel monthly for operational reviews and as well as at a moment's notice based on significant MCO non-compliance. Position will perform highly complex consultative services and technical assistance work. Work involves leading operational and readiness initiatives such as readiness reviews, operational reviews and targeted reviews. Work involves planning, developing, and implementing major agency program(s) and providing consultative services and technical assistance to program staff, governmental agencies, community organizations, or the general public.

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.

The Operational and Readiness Review Specialist reports to the Manager of the Operational and Readiness Review Team in the Managed Care Contracts and Oversight (MCCO) MCS Division. Work also includes research and developing tools for reviews. Position will work in partnership with HHS program staff and contracted MCOs. Work includes evaluating MCO adherence to contracts, policies, programs, other government assistance and programs and private sector resources. Position will contribute to the development of the monitoring teams within MCCO. Position will apprise manager of work-related incidents or situations that could be problematic to staff, the department or the agency. Position will communicate with manager on a timely basis with regard to problematic situations and apply proper judgment to assure action is appropriate. Position works under limited supervision and with considerable latitude for the use of initiative and independent judgment.

Essential Job Functions (EJF)

• Ensure compliance with contract standards and assess MCO performance by reviewing MCO contract deliverables, performance measures and MCO compliance with state and federal regulations.
• On a prompt and regular basis determine the effectiveness of MCO operational and contractual compliance by utilizing a standard set of assessment tools.
• Promptly inform the Senior Manager and team lead of significant MCO compliance and performance issues and provide recommendations for action.
• Facilitate collaboration with other MCCO staff, the MCO, and other external/internal stakeholders to ensure contractual compliance by developing, monitoring, and updating action plans.
• Work promptly and collaboratively to assess and review recommended remedies for noncompliance of contractual requirements.
• Collaborate with MCCO Research and Resolution promptly and timely on escalated MCO related issues.
• Respond to and review legislative, open records and audit requests within specified timeframes.
• Lead and facilitate functions related to operational on-sites, desk reviews, implementations, readiness reviews, information sessions, or other activities as required.
• Manage or facilitate special research/issues projects as assigned within timeframes.
• Develops materials and prepares reports based on findings from readiness reviews.
• Establishes and maintains effective working relationships and communications with HHS staff, and other internal/external stakeholders, and provide timely responses to requests and inquiries.
• Receive 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 inquiries.
• Demonstrates commitment to the goals of the Medicaid/CHIP services, shows initiative to take on new projects, is team-oriented and committed to outstanding customer service, and focuses on promoting efficiencies and accountability.
• Communicates with manager in a timely manner regarding problematic situations and applies proper judgment to ensure action taken is appropriate.
• Attends work on a regular predictable schedule in accordance with agency leave policy. Performs other duties as assigned, timely and accurately.
• Participates in the development of RFPs and the evaluation of RFP responses within assigned timeframes. Reviews, analyzes and evaluates rules, bills and federal/state laws with implications for the Medicaid and CHIP programs as required.

Registration, Licensure Requirements Or Certifications

Certified Texas Contract Manager Certification (CTCM), or must obtain within 12 months upon hire. Must maintain CTCM certification.

Knowledge, Skills And Abilities (KSAs)

• Knowledge of subsidized health insurance, including Medicaid, Medicaid Managed Care, and/or CHIP.
• Knowledge of contract management and compliance principles.
• Ability to work under limited direction and to use initiative and independent judgment.
• Analytical and organizational skills and the ability to conduct investigations or audits; gather, assemble, correlate, and analyze facts and data; and devise solutions to problems.
• Knowledge of state and federal laws, regulations and processes regarding Medicaid Managed Care and CHIP.
• Skill in using personal computer application software such as Microsoft Word, Excel, Power Point, or other similar programs.
• Skill in written and oral communication, including the ability to make public presentations, write technical information in an understandable format, produce sophisticated research and analytical reports.
• Ability to research and evaluate policies and procedures.

Initial Screening Criteria

A minimum of 120 semester hours from an accredited college with major course work in a field related to health and human services. Graduation from an accredited four-year college or university with major course work in a field relevant to healthcare administration, health information technolgy, or management is generally preferred. Experience and education may be substituted on a year for year basis. Minimum of two years of experience with Medicaid and CHIP managed care programs, policies, procedures, contracts, and service delivery models. Minimum of two years of experience of contract management and contract principles. Minimum of two years in/with research, analysis and creating technical reports in an understandable format. Minimum of two years of experience in using a PC and Microsoft Office Suite including: Word, Excel, PowerPoint, Outlook.

Additional Information

In compliance with the Americans with Disabilities Act (ADA), HHS 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 AccessHR service center at 1-888-894-4747. If you are contacted for an interview and need accommodation to participate in the interview process, please notify the person scheduling the interview.

There are no direct military occupation(s) that relate to the initial selection criteria and registration or licensure requirements for this position. All active duty, reservists, guardsmen, and veterans are encouraged to apply.

Review our Tips for Success when applying for jobs at DFPS, DSHS and HHSC.

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 1-888-894-4747. 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 Form

Telework 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.

Nearest Major Market: Austin