Program Specialist V

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Functional Title: Program Specialist V 
Job Title: Program Specialist V 
Agency: Health & Human Services Comm 
Department: Provider Claims Svcs (75/25) 
Posting Number: 21267 
Closing Date: 09/24/2026 
Posting Audience: Internal and External 
Occupational Category: Office and Administrative Support 
Salary Range: $4,523.16 - $5,888.50 
Pay Frequency: Monthly
Salary Group: TEXAS-B-21 
Shift: Day 
Additional Shift:  
Telework: Eligible for Telework 
Travel: Up to 10% 
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) seeks highly qualified candidates to fill a Program Specialist V position within the Claims Management Division, Provider Claims Services (PCS) contact center.

Under the supervision of the PCS Manager, the Program Specialist V performs advanced technical work including training new staff and planning, developing, documenting, and implementing section policy and procedure related to service authorizations and payments in the Long-Term Care (LTC) Claims Management System (CMS).

Researches section and technical requirements to resolve problems and recommends CMS improvements as needed. Escalates issues to the appropriate areas. Provides technical assistance to LTC regional and state program staff. Coordinates development and dissemination of claims payment information to provider agencies and staff. Performs testing on automated systems. Plans and implements section projects and oversees other staff as assigned. May be required to answer provider calls as necessary.

Essential Job Functions (EJFs): 

Represents PCS at workgroups and meetings both internal and external to the agency. (20%)

Provides training to new employees and “on demand” training when necessary. (20%)

Participates in section and automation projects overseeing other staff as assigned. (20%)

Acts as lead and provides technical assistance to regional and state staff and managed care organizations. (15%)

Plans, analyzes, coordinates, and develops PCS section policies and procedures for LTC programs. (15%)

Performs testing on automated systems. (10%)

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

Knowledge, Skills and Abilities (KSAs): 

Knowledge of claims or payment processing systems/applications.

Skill in reviewing/preparing technical documentation.

Skill in analyzing data.

Skill in testing automated systems.

Ability to work with internal and external stakeholders.

Ability to train/lead employees.

Ability to communicate effectively both verbally and in writing.

Ability to work independently and in teams.

Ability to develop spreadsheets and reports using Microsoft Excel.

Registrations, Licensure Requirements or Certifications: 

N/A 

Initial Screening Criteria: 

Bachelor’s degree from an accredited college or university; or a high school diploma or equivalent and related full-time experience may substitute for the required education on an equivalent year-for-year basis.

Experience in delivering staff training required.

Experience testing automated systems required.

Experience reviewing and preparing technical documentation required.

Two or more years of work experience in a call center environment required.

Two or more years of work experience with Medicaid for long-term care programs required.

Additional Information: 

1. 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.

2. Any employment offer is contingent upon available budgeted funds. The salary offered will be determined in accordance with budgetary limits and the requirements of HHSC Human Resources Manual.

3. Applicants must live or be willing to relocate to the Austin area as training is done in office.

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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.