Quality Assurance Specialist

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 Assurance Specialist 
Job Title: Contract Specialist IV 
Agency: Health & Human Services Comm 
Department: CCPM Billing and PMT 
Posting Number: 8467 
Closing Date: 09/09/2025 
Posting Audience: Internal and External 
Occupational Category: Community and Social Services 
Salary Group: TEXAS-B-22 
Salary Range: $4,801.16 - $6,281.33 
Pay Frequency: Monthly
Shift: Day 
Additional Shift: Days (First) 
Telework: Eligible for Telework 
Travel: Up to 50% 
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: Houston; Grand Prairie; San Antonio 
MOS Codes: 3006,3044,8640,310X,36A,36B,51C,60C0,62S0,63G0,63S0,64PX,651X,6C0X1,751X,FIN10,LS,LSS,SEI16,SK,F&S 
 
 
 

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 Quality Assurance Specialist-Contract Specialist IV. MCS is driven by its mission to deliver quality, cost-effective services to Texans. 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. This position performs advanced (senior-level) consultative services and technical assistance services to HHSC program and contract management staff, provider monitoring, program providers, contractors, consumers, family members and guardians, and advocates of Medicaid Waiver Programs such as the Community Living Assistance and Support Services (CLASS), Deaf-Blind with Multiple Disabilities (DBMD), Home and Community based Services (HCS), Texas Home Living (TXHML), and Financial Management Service Agencies (FMSA). The position conducts, coordinates, and leads quality assurance of monitoring staff activity, special projects; provides technical assistance for the division; researches and analyzes highly complex projects or initiatives; prepares management responses and reports; performs highly advanced contract management work, involving the development and evaluation of a broad range of contracts. This position works under minimal supervision with extensive latitude for the use of initiative and independent judgement. Completion of work requires initiating and implementing new methods and/or techniques for quality assurance of monitoring activity or reviews. May plan, assign, train, and/or supervise the work of others.

This position reports directly to the Director of Provider Monitoring within the Contract Administration and Provider Monitoring unit.

Essential Job Functions (EJFs):

Works collaboratively across MCS to identify innovative and effective solutions for clients and staff.

Attends work on a regular and predictable schedule in accordance with agency leave policy and performs other duties as assigned. 

EJF 1 (40%): Develops, implements, and oversees quality assurance oversight activities for the provider monitoring unit including reviewing of monitoring staff assignments and providing advanced level consultative work with monitoring staff and stakeholders. May develop policy and procedure manuals.

EJF 2 (20%): Assists in preparing justifications for the implementation of procedural or policy changes. Assists in the review of program area functions and operations, in identification of areas of needed changes, and in the development of plans to improve or initiate programs or to address areas of concern. Assists in analyzing the business practices related to fiscal and contract compliance to develop corrective action.

EJF 3 (20%): Prepares written reports for tracking performance measurements. Provides tracking for recoupments including reporting and complies with HHSC’s and internal provisions of tracking, letters, and communications. Effectively communicates with internal and external stakeholders.

EJF 4 (10%): Acts as liaison with consumers, agencies and internal program staff to explain and provide technical assistance on agency and program statutory requirements. Collaborates on analysis and documentation of program policies. Provides technical assistance and training via telephone and in person to providers regarding the billing guidelines and Texas Administrative Code to facilitate compliance with contract requirements.

EJF 5 (10%): Prepares justifications for procedural changes, administrative reports, studies, and specialized research projects. May be involved in strategic planning activities with decision-making authority based on broad principles and guidelines. Reviews and analyzes legislation related including tracking legislative bills and assisting with bill analysis.  Develops rapid responses to legislative inquiries and other external and internal requests for information.  Performs other tasks as assigned.

Knowledge, Skills and Abilities (KSAs):

Knowledge of local, state, and federal laws related to Medicaid Waiver Programs serving individual with intellectual or developmental disabilities; of public administration and management techniques; of statistical analysis processes; of research techniques; of program planning and implementation; of administrative and management techniques; of project management practices, procedures and implementation.

Ability to analyze, synthesize and summarize proposed changes to state laws, program rules and regulations. Ability to gather, assemble, and correlate facts. Ability to make decisions and devise solutions to problems and to provide leadership and staff advice. Ability to express oneself clearly orally and to write or compile concise strategic or operational reports, legislative reports, studies and presentations, as needed. Ability to write and evaluate procedures. Ability to support the work of others. Ability to work with diverse groups, stakeholders, agency departments and leaders.

Skill in formulating written communication for various audiences, managing cross-organizational projects, managing competing priorities using personal computing devices. Intermediate skills in operating a computer and applicable software, specifically Excel, SharePoint, PowerPoint and Word.

Registrations, Licensure Requirements or Certifications:

Certified Texas Contract Manager (CTCM) certification must be obtained within one (1) year of employment, if not already certified, unless otherwise approved by Supervisor.

Valid Driver’s License with ability to obtain Texas Driver’s License within 60 days of hire.

Initial Screening Criteria:

Graduation from an accredited four-year college or university with major course work in finance, business, legal, or relevant human services field plus four years’ relevant work experience auditing, quality assurance, compliance oversight, or fiscal monitoring. Additional related work experience may substitute for the required education on a year for year basis with a maximum substitution of four (4) years. Experience in conducting fiscal or compliance monitoring, surveys, reviews or other types of relevant oversight activities, preferred. Experience with interpretation of guidelines, handbooks, laws, rules, policies, and/or statutes. Experience with quality assurance practices, preffered. Experience drafting policies and procedures or internal standard operating procedures, preferred. Experience using Microsoft Office Suite including Excel, Sharepoint, PowerPoint, and Word. The position requires up to 50% statewide travel, including overnight stays.

Additional Information:

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. 

This position will require statewide travel including overnight as required to perform assigned duties. As an employee, it will be necessary to have a valid Texas Driver’s license and have the ability to rent vehicles to perform duties.   

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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.