Provider Enrollment Policy Analyst

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Functional Title: Provider Enrollment Policy Analyst 
Job Title: Program Specialist VI 
Agency: Health & Human Services Comm 
Department: Prov Resol and Admin Appeals 
Posting Number: 8483 
Closing Date: 09/08/2025 
Posting Audience: Internal and External 
Occupational Category: Business and Financial Operations 
Salary Group: TEXAS-B-23 
Salary Range: $5,098.66 - $8,304.83 
Pay Frequency: Monthly
Shift: Day 
Additional Shift:  
Telework:  
Travel: Up to 10% 
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: Austin 
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 & CHIP Services (MCS) department seeks a highly qualified candidate to fill the position of Program Specialist VI (Provider Enrollment Policy Analyst) in the Provider Enrollment (PE) unit. Healthcare providers who want to participate in Texas Medicaid must enroll in the program and periodically revalidate their enrollment. The PE unit oversees the policies, operations, and systems that support the provider enrollment process.
The PE Policy Analyst reports to the Provider Enrollment Manager and performs highly advanced consultative and programmatic support related to PE policy and rule development, operations projects and training activities in a dynamic and fast-paced environment.

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.

Responsible for the development and maintenance of PE operational policy and Texas Administrative Code (TAC) rules. Conducts research and interprets PE policies, procedures, regulations, standards, and rules to other HHSC program areas with PE operational impacts. Provides technical assistance to program and PE staff, providers, managed care organizations, and state Medicaid contractors regarding PE policies and protocols. Prepares complex written reports and presentations for executive management and stakeholders. Leads and participates in PE workgroups as a subject matter expert on PE policy and program initiatives.

Represents PE as a liaison to HHS and its staff, federal and state entities, vendors, and other stakeholders. Identifies, communicates, and directs resolution of complex PE policy issues. Reviews and presents educational deliverables to internal and external stakeholders. Leads and directs team members in areas of responsibility.
                                                                         

Essential Job Functions:

Policy and Rules Development (25%) – Develops and maintains PE operational policy and PE TAC rules. Plans, conducts research, and coordinates program policies and rules with other HHSC program areas. Solicits and analyzes stakeholder feedback on proposed policies; adjusts policies based on feedback, as appropriate. Serves as the primary PE subject matter expert on PE policy and rules.

Technical Support (20%) – Provides consultation to other program areas in the implementation of PE policies (monitoring tools, contracts, handbooks and other documentation). Coordinates with other HHSC programs on policies and procedures that affect PE. Performs consultative and programmatic support related to training activities. Works with technical and operational staff to develop and align PE processes and policies.

Research and Analysis (20%) – Conducts research and analyzes state PE operational policies, state and federal legislative mandates, rules and regulations for impact on PE process and procedures and develops recommendations for policy changes as needed. Monitors for changes in state and federal requirements that impact PE and assesses impacts. Interprets policies, procedures, rules, regulations and standards related to PE. Performs research on other HHSC program area processes and policies for impacts to PE. Analyzes proposed system changes for compliance with PE policy requirements. Performs legislative bill analysis.

Communications (15%) – Identifies, communicates, and directs resolution of complex PE policy issues. Responds to inquiries and requests from internal and external stakeholders regarding PE policy. Prepares executive presentations and reports. Responds to legislative inquiries. Leads and participates in public stakeholder workgroups. Communicates with industry stakeholder groups such as provider associations and advocacy organizations.

Special Projects (10%) – Leads and participates in operational projects affecting the unit. Coordinates with other program areas with minimal oversight. Leads and directs team members in areas of responsibility. May train other staff. Performs other duties as assigned by the PE Manager and MCS leadership.

Complaints and Escalations (10%) – Assists the HHSC Agency with provider enrollment related complaints, escalations, and requests for information. Provides accurate, comprehensive and timely responses to escalations and complaints.

Knowledge Skills Abilities:

Knowledge or experience with Medicaid provider enrollment preferred.

Knowledge of Medicaid or other HHSC programs preferred.

Knowledge of the Texas rule making process preferred.

Skill in leading workgroups and in making presentations.

Skill in developing accurate, clear, and succinct program policies.

Skill in interpreting, researching and evaluating program policy, rules, procedures and operations.

Skill with verbal and written communication.


Ability to lead large groups and coordinate with other departments.

Ability to establish and maintain strong working relationships with stakeholders.

Ability to work in a dynamic and fast-paced environment.

Ability to prepare complex written reports.
 

Registrations, Licensure Requirements or Certifications:

None.  

Initial Selection Criteria:

Graduation from an accredited four-year college or university with major course work in information technology, business administration, or a related field. Experience and education may be substituted on a year for year basis.

Experience developing, interpreting, researching, and analyzing policy.

Experience developing healthcare, organizational or government policies.

Experience leading workgroups or special projects.

Experience communicating complex ideas to stakeholders.

Experience leading operational projects or coordinating with other departments to implement policies or processes.

Additional Information:

1. Your application must be complete and contain all the requested information. Job histories must demonstrate how you meet the initial selection criteria at a minimum.
2. Any employment offer is contingent upon available budgeted funds. The offered salary will be determined in accordance with budgetary limits and the requirements of HHSC Human Resources Manual.
3. This position may be eligible for telework in accordance with the HHSC Telework Policies, which includes in-office attendance three days a week. Telework policies are subject to change.
 

MOS Code:

Note: There may be no military occupation(s) that relate to the initial selection criteria and registration or licensure requirements for this position. All active duty military, reservists, guardsmen, and veterans are encouraged to apply if qualified to fill this position. For more information see the Texas State Auditor's Military Crosswalk at http://www.hr.sao.state.tx.us/Compensation/JobDescriptions.aspx  

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.