Quality Analyst (PSV)

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: Quality Analyst (PSV) 
Job Title: Program Specialist V 
Agency: Health & Human Services Comm 
Department: Quality Assurance 
Posting Number: 9633 
Closing Date: 10/31/2025 
Posting Audience: Internal and External 
Occupational Category: Community and Social Services 
Salary Group: TEXAS-B-21 
Salary Range: $4,523.16 - $7,253.83 
Pay Frequency: Monthly
Shift: Day 
Additional Shift: Days (First) 
Telework:  
Travel: Up to 5% 
Regular/Temporary: Regular 
Full Time/Part Time: Full time 
FLSA Exempt/Non-Exempt: Nonexempt 
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 Texas Health and Human Services Commission (HHSC) Medicaid and CHIP Services (MCS) division seeks highly qualified candidates to fill several Quality Analyst (Program Specialist V) positions. The Program Specialist V positions report to the Quality Assurance Director and work as part of the Quality Assurance team within Quality and Program Improvement to improve health outcomes for Texas Medicaid and CHIP members. This position assists with the development and implementation of state and federally-required healthcare quality initiatives for Medicaid and CHIP.

MCS is driven by its mission to deliver quality, cost-effective services to Texans. These positions make 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 candidates thrive 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%) Leads, implements and manages quality improvement projects related to managed care quality assurance and performance improvement initiatives that evaluate, monitor, and directly impact the performance of MCOs and DMOs. Manages complex processes to identify quality gaps to improve reporting, track quality improvements and enhance current systems. Coordinates project design, planning, analysis and reporting.

(20%) Compiles, reviews, tracks, monitors and assists with the analysis of MCO's quality deliverables and reports. Reviews quality deliverables for completeness and accuracy of data and documentation, and helps ensure compliance with established procedures, contract requirements, laws and regulations. Provides consultative services and technical assistances to MCOs and DMOs on applicable topics and works with MCOs staff to resolve quality-related policy and operational issues. Works with multiple stakeholders on complex quality issues. Develops materials for the preparation or follow-up to workgroups and meetings.

(20%) Develops internal policies and procedures; works with other program staff in determining trends and resolving technical problems; works closely with staff across areas in MSC and HHS and with contractors to ensure operational processes and systems are coordinated. Works with staff and external stakeholders to identify risks/issues and develop mitigation strategies and solutions.

(20%) Performs complex analyses of Medicaid and CHIP managed care performance data and reports related to Healthcare Effectiveness Data and Information Set (HEDIS) quality metrics, potentially preventable events, and member surveys. Reviews technical reports, datasets and analyses completed by Texas’s external quality review organization (EQRO). Analyzes, monitors, and reports on deliverables from the EQRO. Prepares a variety of high-quality memos, summaries, policies and other deliverables containing analyses of Medicaid managed care quality data. Provides oral presentations related to these written materials and reports.

(10%) Analyzes the impact of state and federal laws and regulations on managed care quality. Conducts research on policy implications and helps analyze the effectiveness of the Medicaid and CHIP program. Identifies and operationalizes new requirements for programs and mitigates potential risks. Oversees the collection, analysis, organization and preparation of materials in response to leadership and legislative requests for quality related program information and reports. Serves as subject matter expert on quality metrics, state and federal Medicaid and CHIP managed care quality requirements, healthcare quality concepts, and Texas Medicaid and CHIP quality initiatives.  

Knowledge Skills Abilities:

Knowledge of:

Medicaid and/or CHIP managed care. Knowledge of state and federal laws, regulations and processes regarding Medicaid and/or CHIP managed care.

Healthcare quality and/or quality metrics.

Skill in:

Synthesizing, analyzing and evaluating highly complicated and technical information and translating it into easily understandable and concise documents and oral presentations for agency executives and the public.

Exercising initiative, creativity, and self-direction.

Ability to:

Work collaboratively across MCS to accomplish objectives.

Analyze reports and summarize complex information into easily understandable and concise documents and oral presentations for agency executives and the public.

Research, evaluate, and develop policy and programmatic documents.

Manage multiple projects or assignments with tight deadlines.  

Solve complex problems.

Registrations, Licensure Requirements or Certifications: 

N/A

Initial Screening Criteria: 

Graduation from an accredited four-year college or university or equivalent related work experience. Master’s degree preferred. Experience in healthcare quality, policy, evaluation, project management, or data analysis. 

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.