MCO Assessment and Innovation Team Lead

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: MCO Assessment and Innovation Team Lead 
Job Title: Program Specialist VII 
Agency: Health & Human Services Comm 
Department: Quality Assurance 
Posting Number: 8687 
Closing Date: 09/19/2025 
Posting Audience: Internal and External 
Occupational Category: Healthcare Support 
Salary Group: TEXAS-B-25 
Salary Range: $5,797.66 - $9,508.25 
Pay Frequency: Monthly
Shift: Day 
Additional Shift:  
Telework:  
Travel:  
Regular/Temporary: Regular 
Full Time/Part Time: Full time 
FLSA Exempt/Non-Exempt: Exempt 
Facility Location:  
Job Location City: AUSTIN 
Job Location Address: 701 W 51ST ST 
Other Locations:  
MOS Codes: 16GX,60C0,611X,612X,63G0,641X,712X,86M0,86P0,88A0,88B0,8U000,OS,OSS,PERS,YN,YNS 
 
 
 

Brief Job Description

The Texas Health and Human Services Commission (HHSC) Medicaid and CHIP Services (MCS) division seeks a highly qualified candidate to fill the position of Team Lead (Program Specialist VII) for Managed Care Organization (MCO) Assessment and Innovation. The Team Lead reports to the Quality Assurance Director within Quality and Program Improvement to improve health outcomes for Texas Medicaid and CHIP members. This position works under minimal supervision with extensive latitude for the use of initiative and independent judgment. The Team Lead performs highly advanced consultative and technical work, including developing and implementing healthcare quality initiatives and evaluating the performance of contracted MCOs.

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 using data-driven evidence-based approaches to hold Medicaid and CHIP MCOs accountable, ensure access to high-quality care, and drive quality-based innovation. 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:

(30%) Develops and manages highly complex initiatives that evaluate and directly impact the performance of managed care organizations within the Medicaid and CHIP managed care programs. Researches and analyzes the implications of new and existing state and federal policies and legislation related to healthcare quality. Interprets agency rules and federal and state laws. Oversees compliance with program policies, procedures, statutes, and rules(30%) Identifies opportunities for process improvements. Suggests and implements changes to improve efficiency and effectiveness of quality initiatives delivered through managed care. Develops recommendations relating to changes in programs and operational policies related to managed care and provides input related to health quality initiatives. Develops and implements solutions to address operational challenges. Works with program staff in determining trends and resolving technical problems. Coordinates with staff across areas and agencies and with contractors; acts as a liaison with agencies and internal programs to explain and provide technical assistance on agency and program requirements. Recommends and coordinates activities to produce more effective programs. Identifies quality gaps, improves reporting processes, tracks quality improvements and enhances current systems.

(20%) Serves as team lead for the MCO Assessment and Innovation team. Plans and prioritizes the work of the team, including overseeing the work of two staff. Manages complex program initiatives and projects. Provides guidance to staff across teams in the development and integration of new processes.

(20%) Reviews and analyzes quality performance information including technical reports, datasets, and analyses completed by Texas’s external quality review organization. Prepares high-quality analyses, summaries, and other documents as assigned. Develops reports, policies and procedures, and analysis tools. Works with other areas of MCS to review and improve understanding of quality metrics and reports and develops strategies to improve health plan performance. Provides consultative services and technical recommendations to MCOs on applicable topics and works with MCOs’ staff to resolve technical and operational issues. Facilitates and participates in workgroups, setting goals and objectives and providing work products related to managed care programs and policy. Works collaboratively across MCS, HHS, and contractors to identify innovative and effective solutions. 

Registrations, Licensure Requirements, or Certifications:

N/A

Knowledge, Skills, Abilities:

Knowledge of:

• State and federal laws, regulations, and processes regarding Medicaid managed care
• Healthcare quality concepts, quality assurance practices, and performance monitoring and improvement
• Power platform tools

Skill in:

• Understanding and solving complex problems
• Project management
• Leading teams
• Planning and organization
• Written and oral communication, including synthesizing highly complicated and technical information and translating it into easily understandable and concise documents and oral presentations for a variety of audiences
• Legislative analysis

Ability to:

• Serve as a team lead, providing direction to others
• Think strategically
• Provide guidance across teams
• Lead workgroups, work with multiple stakeholders, and provide oversight to contracted vendors
• Work collaboratively across MCS to accomplish objectives
• Identify and implement creative solutions to problems
• Perform work with a high degree of attention to detail
• Balance team and individual responsibilities
• Manage multiple projects or assignments 
• Analyze data to identify trends, problems, and issues
• Develop and interpret statistical data, charts, maps, and tables
• Exercise initiative, creativity, and self-direction in developing solutions and enhancements to existing programs and initiatives

Initial Screening Criteria:

Required:

• Graduation from an accredited four-year college or university.
• Experience with Medicaid, healthcare quality, managed care, or another large-scale healthcare delivery system.
• Experience leading projects or initiatives and addressing complicated issues or problems including analyzing policies, data and other complex information.
• Experience in communicating, including making presentations and preparing technical information in an understandable format for internal management and external publication. 

Preferred:

• Master's degree.
• Experience analyzing policies and legislation.
• Experience in the evaluation of health care quality.
• Experience overseeing the work of others.

Additional Information 

N/A

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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.