Provider Services Management Analyst

About the role

The Texas Health and Human Services Commission (HHSC) Medicaid CHIP Services (MCS) division seeks a highly qualified candidate for the position of Management Analyst IV, reporting to the Director of Provider Services within MCS Operations Management.

Responsibilities

• Interprets policies, procedures, rules, regulations and standards related to the program.
• Performs legislative bill analysis.
• Interfaces with other areas in HHSC, other State agencies, vendors, and CMS to help interpret rules and policy.
• Provides technical and analytical assistance to the Provider Services area.
• Reviews processes and workflows to identify and recommend areas for improvement.
• Conducts root cause analysis and helps to develop corrective action plans when undesired situations occur.
• Provides consultation and recommendations to division leadership that align with organizational objectives, policies and practices.
• Works with internal and external stakeholders, including contracted vendors, to research and disposition complex provider questions and complaints.
• Provides senior-level support to the Director of Provider Services and the Provider Services area.
• Prepares executive-level briefings, decision documents, memoranda, legislative responses, formal correspondence, presentations, and talking points.
• Manages projects and assignments to ensure timely completion of work impacting the unit.
• Develops and manages project charters, timelines, resource plans, status reports, and other deliverables.
• Led and monitors projects, advises on emerging issues, ensures deliverables meet agency standards.
• Supports Provider Services by managing priority assignments, advising on emerging issues, and ensuring deliverables meet agency standards.
• Serves as a key liaison across MCS, HHSC, and external stakeholders to coordinate complex assignments, represent Operations Management in cross-agency efforts, and support timely decision-making.
• Leads and monitors projects, analyzes legislative and regulatory impacts, identifies policy and operational risks, recommends solutions, collects and analyzes data in areas such as workload, operational, business, and managerial practices, and contributes to process improvements and policy development.

Requirements

• Graduation from an accredited four-year college or university with major coursework in public administration, public policy, business administration, health care administration, social work, communications, or a related field.
• Relevant work experience may substitute for education on a year-for-year basis.
• Three years of experience conducting management analysis such as evaluating an organization's operations, systems, and finances to recommend ways to improve efficiency or conducting root cause analysis of operational failures and drafting mitigating corrective action plans.
• Three years’ experience working in the healthcare industry.

Qualifications

• Experience supporting executive leadership, senior management, boards, commissions, or other high-level decision-makers.
• Experience with billing, claims processing, or authorizations systems or processes preferred.

Skills

• Knowledge of Medicaid and CHIP operations, including key program functions such as provider enrollment, claims and encounters management, service authorization support, and electronic visit verification.
• State and federal laws, regulations, and legislative processes affecting Medicaid and CHIP services.
• Project management principles, methodologies, and best practices.
• Operational improvement and process analysis methodologies.
• Principles of organizational coordination, stakeholder engagement, and change management.
• Ability to synthesize complex information into clear summaries and recommendations.
• Manage projects, assignments, timelines, resource plans, and status reports.
• Critical thinking to identify problems, evaluate options, and recommend practical solutions.
• Effective communication skills, including leading large workgroups and making presentations.
• Use of Microsoft Office tools including: Outlook, Word, Power Point, Teams and Excel.
• Complex verbal and written communication.
• Web conferencing tools such as GoToMeeting & Teams.

Benefits

The 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.