Program Policy Advisor (Program Specialist VI)

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Functional Title: Program Policy Advisor (Program Specialist VI) 
Job Title: Program Specialist VI 
Agency: Health & Human Services Comm 
Department: Program Policy Spec B 
Posting Number: 9612 
Closing Date: 10/28/2025 
Posting Audience: Internal and External 
Occupational Category: Community and Social Services 
Salary Group: TEXAS-B-23 
Salary Range: $5,098.66 - $8,304.83 
Pay Frequency: Monthly
Shift: Day 
Additional Shift:  
Telework:  
Travel: Up to 20% 
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,86M0,8U000,OS,OSS,PERS,YN,YNS 
 
 
 

Brief Job Description:

The Program Policy team within Medicaid and CHIP Services (MCS) Office of Policy is seeking a highly qualified candidate to fill the position of Policy Advisor (Program Specialist VI). This position serves as a team lead and subject matter expert for Medicaid and CHIP program policy related to Community First Choice (CFC) and Personal Care Services (PCS) for the STAR program.

 
The Policy Advisor:

• Performs highly advanced, consultative and technical work related to the planning, development, implementation, and maintenance of CFC and PCS in the STAR program;
• Collaborates with and provides technical assistance and oversight to Department of State Health Services (DSHS) Regional Specialized Health and Social Services (SHSS) case management and liaison staff; 
• Analyzes, develops, and revises program policy, including contract requirements, administrative rules, manuals, and procedures; 
• Works with internal and external stakeholders, including other governmental agencies, managed care organizations, provider associations, people receiving services, and advisory committee members;
• Authorizes services for and solves billing issues related to PCS and CFC;
• Identifies and resolves problems to address program needs;
• Assists in ensuring compliance with program policies and procedures, statutes, and rules;
• Implements complex program initiatives;
• Serves as agency liaison to committees or workgroups;
• Prepares high quality written reports, correspondence, and other documents
• Drafts legislative reports;
• Leads meetings;
• Responds to inquiries;
• Develops and provides training; and
• Analyzes legislation.

The position is not supervisory but may assign, oversee, and prioritize work of others. The position will work under limited supervision, with considerable latitude for the use of initiative and independent judgment. This position reports to a Manager for Program Policy in the Office of Policy, Medicaid.

Essential Job Functions:

(20%) Provides policy development and oversight for case management providers and DSHS regional staff. Develops and updates policy and procedure manuals and related forms for Personal Care Services/Community First Choice in accordance with program objectives and goals. Provides technical assistance to providers and DSHS regional managers on policy implementation and clarification. Reviews and updates, as needed, rules and the Texas Medicaid Provider Procedure Manual. Analyzes legislation to develop recommendations for policy and programmatic issues relating to implementation, improvement, and program funding.

(20%) Provides guidance and consultative services to providers and DSHS regional staff in the development and integration of new methods and procedures, and to plan and monitor the effectiveness of agency programs. Collects, organizes, analyzes, and prepares material in response to requests for information and reports. Develops and provided training to DSHS staff, HHSC staff, and other stakeholders. Conducts special projects, initiatives, directives, or duties as assigned in support of HHSC division, department, unit, or section.

(15%) Ensures client eligibility by establishing service criteria. Approves/denies prior authorizations or gives guidance in the authorization of the level of service for programs. Receives and processes referrals for Community First Choice Program. Problem solves billing issues with case management providers and PCS/CFC case managers through Medicaid leadership or contractors.

(15%) Investigates and resolves complaints from and communicates outcomes to DSHS regional staff, Medicaid providers, clients and families, Medicaid leadership, Office of Ombudsman, and community members. Examines trends and establishes corrective measures as appropriate. Liaisons with appropriate investigatory agencies.

(10%) Plans, organizes, and implements training/ongoing education for providers and DSHS regional staff in accordance with program objectives and goals. Provides technical assistance to DSHS regional staff to assist in planning/developing educational programs on PCS/CFC.

(5%) Engages with community groups to coordinate, improve, and promote programs. Speaks to participants in statewide professional conferences for the purpose of program education, outreach, and provider recruitment.

(5%) Serves as a liaison with various programs/units in HHSC, DSHS Regional SHSS, Department of Family and Protective Services, state and national organizations, and professional licensing boards related to programs. 

(5%) Prepares high quality written documents, including program and project updates, memos, summaries, legislative reports, rules, waivers, state plan amendments, and other documents.

(5%) Completes other duties as assigned

Registrations, Licensure Requirements or Certifications:

None required, but a current license to practice social work or nursing in the State of Texas is one of the preferred screening criteria.

Knowledge, Skills, and Abilities:

Knowledge of: 
• Federal and state laws and regulations related to Medicaid and the CHIP;
• Legislative process and experience analyzing legislative bills;
• Government organization and administration; 
• MCS and HHSC processes related to the administration or provision of Medicaid and CHIP benefits; and
• Policy development and research methods.

Skills in:

• Analyzing and evaluating complex federal and state legislation, program policy, and operations issues;
• Researching with regard to Medicaid policy;
• Developing and implementing creative and workable solutions to complex problems;
• Translating policy and technical information into easily understandable and concise documents and oral presentations;
• Using Microsoft Office products, including SharePoint and Teams;
• Developing creative and workable solutions to complex problems and policy issues; and
• Facilitating meetings with external stakeholders and other project or agency partners.

Ability to:

• Work cooperatively as a team member in a fast-paced, deadline-oriented environment;
• Work with a team under pressure, negotiate with multiple parties, and resolve conflicts;
• Establish and maintain effective working relationships with various levels of personnel in government entities;
• Exercise judgement and work independently with minimum supervision;
• Serve as lead staff and provide effective direction to and oversight of other staff; and
• Communicate effectively orally and in writing.

Initial Screening Criteria

Candidates must meet one of the following:

1) Bachelor’s degree from an accredited four-year college or university and at least two years' full-time work experience in health and human services;

2) Master’s degree in nursing, social work, public affairs, public health, or public administration and at least one year of full-time work experience in health and human services; or

3) High school diploma and at least five years’ full-time work experience in a health and human services field.

Preferred Screening Criteria:

• Work experience researching and analyzing complex policy issues and communicating the analysis in clear and concise policy documents.
• Work experience in Medicaid or CHIP Services or Texas Health Steps or with Local Intellectual and Developmental Disability Authorities (LIDDAs).  

Additional Information:

Additional information about the programs this position supports can be found on the 2024 edition of the Texas Medicaid Pink Book https://www.hhs.texas.gov/sites/default/files/documents/texas-medicaid-chip-reference-guide-15th-edition.pdf.

HHSC is a qualifying organization for the Federal Public Service Loan Forgiveness Program, which forgives the remaining balance on college student Direct Loans after making 120 qualifying monthly payments.

Additional benefits of joining the MCS Office of Policy include:

• Leadership commitment to invest in and foster your professional growth and career advancement.
• Being part of a team that impacts the lives of millions of Texans that depend on Texas Medicaid throughout Texas.
• Being on the ground level of healthcare policy development and implementation, including the opportunity to work closely with stakeholders such as federal partners, providers, advocates, managed care organizations, and other healthcare contractors.
• Engagement with the Texas legislative process, including the opportunity to analyze and inform legislators of potential impact of proposed bills.
• The opportunity to learn and engage with multiple domains of the healthcare delivery system, including managed care, fee-for-service, federal-state Medicaid partnerships and other activities related to the administration of the Medicaid program.

The position is located in Austin and requires regular in-office attendance.

The final salary offer is dependent on factors such as Human Resources policies and available budget.

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.