Strategic Managed Care Contract & Oversight Specialist

FALL CREEK FARM & NURSERY; Austin (TX); Hybrid; USD 48,000 - 62,000; Full time

Benefits offered by this job

Health insurance

Defined benefit pension

Generous time off benefits

Career advancement opportunities

Job summary

Health & Human Services Commission in Austin seeks a Program Specialist IV to monitor managed care contracts and oversight. You will analyze MCO performance, ensure compliance with state and federal rules, and coordinate with internal and external stakeholders to implement corrective actions.

The role demands strong analytical, communication, and regulatory knowledge, with some travel and potential telework options. A bachelor's in a health-related field is preferred.

Qualifications

• Graduation from an accredited four-year college or university; major in Health Care Management or Administration preferred.
• Experience with Medicaid/CHIP, managed care programs, contracts, and service delivery required.
• Proficiency in Microsoft Office and data analysis is necessary.

Responsibilities

• Ensure contract standards and assess MCO performance and compliance.
• Monitor MCO operations using standard assessment tools and actions.
• Communicate issues to Health Plan Manager and propose corrective actions.
• Collaborate with stakeholders to maintain contractual compliance and update action plans.
• Respond to legislative, open records, and audit requests timely.

Skills

Medicaid knowledge

Contract management

Regulatory knowledge

MS Office

Research & analysis

Communication skills

Education

Bachelor's degree in Health Care Management or Administration

Tools

Microsoft Word

Excel

PowerPoint

Job description

Health & Human Services Commission in Austin seeks a Program Specialist IV to monitor managed care contracts and oversight. You will analyze MCO performance, ensure compliance with state and federal rules, and coordinate with internal and external stakeholders to implement corrective actions.

The role demands strong analytical, communication, and regulatory knowledge, with some travel and potential telework options. A bachelor's in a health-related field is preferred.