Provider Enrollment Specialist

Career Opportunities: Provider Enrollment Business Analyst (20511) Posting ID 20511 -Posted - Health & Human Services Comm - Prov Resol and Admin Appeals - Business and Financial Operations - Eligible for Telework - c. $5000 - $6999 per month 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: Provider Enrollment Business Analyst Job Title: Information Technology BA III Agency: Health & Human Services Comm Department: Prov Resol and Admin Appeals Posting Number: 20511 Closing Date: 09/07/2026 Posting Audience: Internal and External Occupational Category: Business and Financial Operations Salary Range: $5,797.66-$7,652.91 Pay Frequency: Monthly Salary Group: TEXAS-B-25 Shift: Day Additional Shift: None Telework: Eligible for Telework Travel: Up to 5% 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: None MOS Codes: 8846,8848,8858,14NX,15AX,16KX,181X,182X,1D7X1,255A,25B,26B,62E,681X,682X,781X,782X,CYB10,CYB11,ISM IT,Z Prefix 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 Business Analyst III (BA III) 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. This position will support PE systems including the Provider Enrollment Management System (PEMS). 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. The BA III reports to the PE Manager and serves as a technical lead for the PE program. Activities for this position include working with agile/scrum teams of contracted software vendors to implement system changes; performing analysis of systems and business processes to ensure alignment with business operations; overseeing and coordinating development of business requirements; performing project management tasks; leading external stakeholder discussions to provide track feedback on upcoming system requirements; and participating in PE system compliance reviews and other projects as assigned. Essential Job Functions: Agile Management (30%) – Serves as the technical lead for PE technology projects. Works with agile/scrum teams of contracted software vendors to implement system enhancements, maintenance and changes through the Scaled Agile Framework (SAFe Agile) software development methodology (or other methodologies). Develops, refines, and prioritizes epics, user stories, and product backlog items. Documents project work through reporting tools. Consults with subject matter experts to get input on technology changes. Monitors throughput of scrum team and sprint cycles to ensure performance targets are met. Business Analysis (25%) – Performs analysis of multiple interrelated systems and business processes to ensure alignment with business operations. Coordinates across the PE program and external stakeholders to develop system requirements and business processes that align with strategic goals and objectives. Recommends and oversees the development and integration of new operational or systematic methods and procedures to improve the program and resolve identified issues. Reviews system functionality against documented requirements to determine if the system is performing as expected. Assesses system defects for business impact and verifies that solutions comply with system and program requirements. Ensures severity levels of defects are Assigned correctly. Ensures defects are tested before being promoted into production. Coordinates with HHSC contract management to ensure that defects are resolved timely per the contractual SLAs. Analysis and Requirement Development (20%) – Oversees and coordinates development of business requirements for Provider Enrollment. Analyzes PE systems data, claims processing systems, and other related systems to identify and make recommendations for business requirement updates or new projects. Develops, or assists with developing project intake requests and system change requests. Stakeholder Liaison & Communications (10%) – Represents the PE unit in stakeholder workgroups to elicit business requirements and present proposed solutions. Responds to inquiries. Prepares and approves written reports for department leadership. Ensures communication related to PE Special Projects (10%) - Assists staff with technical research to resolve complaints and provider escalations. Communicates directly with stakeholders to troubleshoot issues and provide resolution. Reviews PE policies and procedures, training deliverables, and other PE Complaints and Escalations (05%) – 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: Knowledge of healthcare IT systems preferred. Knowledge of standard business analysis concepts and practices. Knowledge of the agile software development life cycle. Skills: Skill in analyzing and evaluating complex program and policy issues. Skill in developing and documenting business requirements. Skill in analyzing and evaluating highly complicated information and presenting to stakeholders. Skill in facilitating meetings. Skill in eliciting business needs from subject matter experts. Abilities: Ability to identify and analyze system issues and determine business impacts. Ability to analyze systems and procedures. Ability to communicate effectively. Ability to analyze and interpret state and federal laws, regulations, and policies. Ability to train and lead teammates. Ability to evaluate systems for compliance with business and technical requirements. Registration or Licensure Requirements: Certified Scrum Product Owner or Certified Scrum Master (CSM) preferred. 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 in developing business or technical requirements for automated systems. Experience facilitating review of business or technical requirements with stakeholders. Experience with product ownership. Experience working with an Agile (Scrum or similar) team. Experience with state or federal government healthcare programs or policy preferred. Experience working with healthcare systems preferred. Experience working with third-party developers 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. The offered salary will be determined in accordance with budgetary limits and the requirements of HHSC Human Resources Manual. Interviews may be conducted online via Microsoft Teams. Applicants should have ability to meet using virtual meeting tools. 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. Applicants selected for an interview will complete an in-basket exercise as part of the interview process. 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 tothose 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 View phone number on click.appcast.io. 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. #J-18808-Ljbffr