PE Specialist- Medicaid, CHIP and Health Texas Women

Overview Date: Jun 18, 2026 Location: AUSTIN, TX 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. Job Details Functional Title: PE Specialist- Medicaid, CHIP and Health Texas Women Job Title: Program Specialist IV Agency: Health & Human Services Comm Department: HTW ADMIN 1115 Posting Number: 18134 Closing Date: 07/02/2026 Posting Audience: Internal and External Occupational Category: Business and Financial Operations Salary Range: $4,263.16 - $6,779.25 Pay Frequency: Monthly Salary Group: TEXAS-B-20 Shift: Day Telework: Eligible for Telework Travel: Up to 10% Regular/Temporary: Regular Full Time/Part Time: Full time FLSA: 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 Responsibilities 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 IV (PE Specialist) in the Provider Enrolment (PE) unit. The specialist will serve as a provider enrollment expert with a specialization in Healthy Texas Women (HTW), focusing on PE program operations, policies and workflows in a fast-paced environment. Responsibilities include researching and interpreting policies, procedures, rules, regulations, guidance, and standards related to Medicaid provider enrollment daily operations. Key tasks include, but are not limited to: Conducting complex analysis and research and developing recommendations in response to escalated Medicaid, CHIP, and HTW provider issues and operational matters. Assisting with the collection, organization, analysis, and preparation of materials in response to requests for program information and reports. Reviewing literature, statutes, rules, and policies; assisting with justifications for policy changes; developing policy and procedure manuals. Serving as the subject matter expert on projects related to HTW provider certifications, enrollment, and related workgroups/meetings. Reviewing and making determinations in the Provider Enrollment Management System (PEMS) for Operations Management (OM) requests. Identifying root causes of processing delays and recommending gap coverage or backdated enrollments. May serve as backup in PE work groups and may train others. Essential Job Functions (EJFs) Researches, analyzes, and evaluates provider issues, policy issues, and enrollment trends; develops recommendations and reports; participates in policy development; implements policy changes. Coordinates between clients, providers, and contractors to resolve problems and issues. Performs technical and analytical customer service using PEMS and related tools for Medicaid and HTW programs (30%). Leads and participates in provider enrollment and certification projects, workgroups, and meetings; reviews regulations and comments on proposed legislation and program changes. Prepares updates, summaries, and reports; keeps supervisor informed on pertinent issues. Provides technical assistance and assessments of compliance and issues involving providers, contractors, claims processing, and IT systems (20%). Analyzes contractor performance and communicates results and recommendations to program leadership (15%). Analyzes legislation to develop policy recommendations; responds to legislative inquiries; supports implementation of legislative direction (10%). Other duties as assigned (5%). Knowledge, Skills, and Abilities Knowledge: Health and Human Service programs, including Medicaid, CHIP, and HTW; local, state, and federal laws related to these programs; managed care, health care, health insurance programs, and related policies. Skills: Managing multiple priorities; researching, analyzing, and evaluating complex issues; meeting facilitation, problem-solving, and conflict resolution; collaboration with diverse groups. Abilities: Identify problems, evaluate alternatives, implement solutions; communicate effectively; coordinate with staff, agencies, and the public; review and interpret rules; lead workgroups and projects. Qualifications Initial Screening Criteria: Graduation from an accredited four-year college or university. Experience and education may be substituted on a year-for-year basis. Four years of experience in Medicaid, Healthy Texas Women, or other health and human services programs is required. A minimum of 2 years’ experience researching, analyzing, developing, and evaluating Medicaid and/or Healthy Texas Women programs. Experience communicating with external stakeholders is preferred. Additional Information 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. Any employment offer is contingent upon available budgeted funds. Salary determined by budgetary limits and HHSC HR Manual. This position may be eligible for telework in accordance with HHSC Telework Policies; in-office attendance three days a week. Policies may change. Review Tips for Success when applying for jobs at DFPS, DSHS and HHSC. Other Information Active Duty, Military, Reservists, Guardsmen, And Veterans: Qualified applicants encouraged to apply. See Texas State Auditor’s Office resources for Military Crosswalk guidance. ADA Accommodations: HHSC provides reasonable accommodations during hiring; contact the HHS Employee Service Center for assistance. Pre-Employment Checks: Background checks may be required; HHSC uses E-Verify. Bring I-9 documentation on first day. Telework Disclaimer: All HHS positions are subject to telework policies and business needs. Nearest Major Market: Austin #J-18808-Ljbffr Texas Health and Human Services