Senior Manager

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.

Brief Job Description:

The HHSC Medicaid CHIP Services (MCS) division seeks a highly qualified candidate to fill the position of Manager V in the Managed Care Contracts and Oversight (MCCO) Department. 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 ensuring that Medicaid and Children’s Health Insurance Program (CHIP) members obtain covered services delivered through the managed care delivery model.

The ideal candidate thrives in an environment that emphasizes teamwork and collaboration 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. The Manager V performs highly advanced (senior-level) managerial work, complex monitoring, analysis, and oversight activities. The position oversees teams that perform monitoring and oversight of Managed Care Organizations (MCOs), Dental Maintenance Organizations (DMOs), and Non-Emergency Transportation (NEMT) Demand Response Transportation Services (DRTS). Duties include establishing goals and objectives, developing policies and procedures, planning, assigning, and supervising the work of staff. This position works with minimal supervision, with extensive latitude for the use of initiative and independent judgement.

Essential Job Functions:

Oversees assigned teams that monitor MCO, DMO, and NEMT DRTS performance to ensure compliance with the contracts. Assists with the development, implementation and monitoring of corrective action plans to make recommendations for improvements in health plan operations. Develops, collects, and evaluates data through monthly, quarterly, and annual review of deliverables. Reviews reports from regulatory entities, HHSC contractors, and data obtained from other sources. Develops management reports, conducts periodic written evaluations regarding compliance with the managed care contract. Assists in overseeing the identification and resolution of contract issues by working with MCOs, DMOs, and NEMT DRTS providers to improve performance and contract compliance. Investigates and/or follows-up on member or provider complaints. (40%)

Conducts desk and on-site reviews of MCOs, DMOs, and NEMT DRTS providers. Works with program staff in determining trends and resolving technical problems. Develops review materials and documents findings from readiness operational reviews. Analyzes and assesses documents, data and other relevant materials for readiness reviews, or operational reviews. (20%)

Provides guidance in the development of managed care contracts. May assist with the review, analysis and evaluation of rules, bills and federal/state laws with implications for the Medicaid and CHIP programs. Responds to communications with internal and external stakeholders. (20%)

Apprises manager of work-related incidents as situations that could be problematic to staff, the department, or the agency and works on other duties as assigned. Establishes and maintains effective working relationships and communication with MCS, internal and external stakeholders. (20%)

Knowledge Skills and Abilities:

Knowledge of federal and state Medicaid and CHIP laws and regulations.
Knowledge of contract management and contract compliance principles.

Skill in written and oral communication, including the ability to speak publicly and serve as agency spokesperson. 

Skill in working collaboratively and cooperatively with diverse groups.
Ability to establish and maintain effective working relationships 

Ability to research, evaluate, and develop policies and procedures.
Ability to plan, assign and supervise the work of others.

Registrations, Licensure Requirements or Certifications:

Certified Texas Contract Manager (CTCM) preferred or must be obtained within the first 12 months of employment.

Inital Selection Criteria

A minimum of 120 semester hours from an accredited college with major course work in a field related to health and human services. Graduation from an accredited four-year college or university with major course work in management, healthcare administration, or health information technology is generally preferred. Experience in managing staff is required. Experience with contract management principles and techniques is required. Experience with Medicaid and CHIP is preferred. The required experience may be substituted by the education.                                                                                                                                                                                                                        

Additional Information

In compliance with the Americans with Disabilities Act (ADA), HHS 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.

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.