Director of Provider Services

Title: Director of Provider Services

Location: Austin, TX United States

Remote

Job Description:

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: Director of Provider Services

Job Title: Director III

Agency: Health & Human Services Comm

Department: Daily Operations Claims Admin

Posting Number: 14866

Posting Audience: Internal and External

Occupational Category: Business and Financial Operations

Salary Range: $7,716.66 - $13,051.00

Pay Frequency: Monthly

Salary Group: TEXAS-B-28

Shift: Day

Additional Shift:

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:

MOS Codes: 8003,8040,8041,8042,10C0,111X,112X,113X,114X,20C0,30C0,40C0,611X,612X,631X,641X,648X,90G0,91C0,91W0

97E0,SEI15

The Texas Health and Human Services Commission (HHSC) Medicaid and CHIP Services (MCS) division seeks a highly qualified candidate to fill the position of Director of Provider Services. 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 developing and directing activities to improve Texas Medicaid operations and the stakeholder experience.

This position serves as the Director of Provider Services performing advanced managerial work within the Operations Management department of MCS. Under the direction of the Deputy Associate Commissioner for Operations Management, the Director is responsible for managing and leading the Provider Services unit. This unit performs and oversees operations that support our primary customers - healthcare providers that participate in the Medicaid program. The primary functions of Provider Services include:

• Oversight of claims processing, payment, appeals and recoupments;
• Management of provider enrollment;
• Management of electronic visit verification; and
• Operation of a call center to assist providers with service authorizations.

This position must be able to lead in a dynamic and fast-paced environment and effectively manage complex operations involving internal staff, contracted staff, vendors, information technology, and multiple teams that operate within state and federal regulatory frameworks. The position requires a leader with strong change management and strategic planning skills. The Director must be skilled in communicating complex information to executive and external stakeholders.

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.

Essential Job Functions (EJFs):

• Operations Management (30%): Provides strategic oversight by establishing structures, performance expectations, standardized processes and relationships that enable supervisors and staff to effectively manage day-to-day operations. This role is responsible for setting key performance indicators, ensuring appropriate workload management, and maintaining accurate and current process and procedure documentation. The Director drives continuous improvement by identifying operational risks and opportunities, maintaining compliance with evolving statutory and regulatory requirements, and ensuring corrective actions are implemented consistently. The Director ensures that management systems, controls, and accountability mechanisms are in place so teams meet service level expectations and operate efficiently. The Director uses data and performance information to assess organizational effectiveness, identify risks and opportunities, and make informed decisions.
• Personnel Management (20%): Oversees the daily operations of the Providers Services units and supervises direct reports, including directors and managers. Establishes performance expectations, accountability structures, and workforce strategies that enable supervisors to effectively manage their staff. This role is responsible for ensuring timely completion of performance evaluations, establishing and applying consistent performance targets, and holding staff to appropriate standards. The Director oversees workload distribution and position alignment to meet operational needs, ensuring staff are appropriately resourced and equipped to perform their duties. Ensures that supervisors are trained, supported, and accountable for effective workforce management, professional development, and sustained organizational performance.
• Strategic Leadership (20%): Provides strategic leadership by setting clear direction, priorities, and expectations that align unit operations with division, department, and agency goals. Leads and manages organizational change by guiding teams through operational, policy, and system transitions; ensuring stakeholder engagement, readiness, and adoption of new processes; and minimizing disruption to service delivery. Translates organizational strategy into actionable frameworks that guide supervisors and staff in decision‑making, problem solving, and project execution. Represents the division in internal and external settings, including governance meetings, advisory committees, workgroups, and stakeholder meetings.Communicates clearly and effectively with a broad range of audiences to accurately and professionally represent the organization's priorities, positions, and operational direction. Coordinates with peers across the agency to solve problems and maintain operational transparency.
• Project Management (15%): Manage, coordinate, and oversee the development, implementation, and timely completion of projects impacting the unit. This role serves as a project sponsor by setting strategic direction, approving priorities, and ensuring project leads have the guidance, resources, and authority needed to succeed. Responsible for ensuring appropriate risk and issue management, including mitigation and escalation, and identifying and managing cross‑project dependencies within the portfolio. The Director ensures that appropriate project management standards are applied, projects are resourced appropriately, progress is monitored through effective reporting, and issues are escalated and resolved in a timely manner to support successful outcomes. Leads special projects as needed.
• Policy Management and Legislative Support (15%): Provides leadership and oversight for policy and legislative activities within the unit's scope of responsibility. Analyzes proposed state and federal legislation to assess operational, fiscal, and programmatic impacts, and coordinates with other teams to support enterprise analysis. Oversees the development, maintenance, and implementation of program rules, policies, handbooks, and related guidance to ensure compliance with regulatory requirements. Serves as a subject matter expert and represents the agency as a resource witness during legislative hearings and briefings. Translates policy and legislative changes into actionable operational requirements, ensuring timely and effective implementation of process and workforce changes necessary to maintain compliance and support program objectives.

Knowledge, Skills and Abilities (KSAs):

Knowledge of:

• Leadership principles for managing varied professional staff and agency resources.
• Principles and practices of contract administration and management.
• Project management principles and techniques.
• Information technology systems and business services.
• Financial and budgetary data analysis.
• Personnel management, human resources policies and practices.
• State of Texas legislative process is preferred.
• State and federal health and human services programs and regulations relevant to Texas Medicaid is preferred.

Skill in:

• Strong analytical, strategic conceptual thinking, planning, and execution.
• Excellent verbal and written communication, capable of explaining complex information to a variety of stakeholders.
• Managing and executing complex projects on time and within budget.
• Developing and leading diverse teams, ensuring effective workforce management, professional development, and sustained organizational performance.
• Conflict resolution, problem-solving, and making sound judgments under pressure.

Ability to:

• Motivate staff to obtain a standard of excellence in their work and to foster an environment of continuous improvement.
• Work collaboratively across the organization with diverse teams and stakeholders to accomplish objectives.
• Balance team and individual responsibilities.
• Manage complex operations involving people, information technology systems, and multiple vendor handoffs.
• Adapt strategies based on changing technology landscapes and business needs.
• Build and maintain strong partnerships with internal and external stakeholders.
• Continuously learn and adapt to new concepts and evolving business needs.

Registrations, Licensure Requirements or Certifications:

Certified Texas Contract Manager preferred

Initial Screening Criteria:

Required:

• 5 years of personnel management, with a preference for those who have managed multiple levels of staff (i.e., has been a second-level manager or higher).
• Work history demonstrating progressive professional growth.
• Experience performing or managing operations including but not limited to call centers, claims processing, provider enrollment or credentialing, or other high volume processing work.
• Experience managing cross-functional teams or projects, involving information technology, contracting, operations, or other related functions.

Preferred:

• Graduation from an accredited four-year college or university with major course work in business administration, public administration, management, or related field is strongly preferred.
• Experience with Medicaid operations.
• Experience with state government legislative process and bill analysis.
• Experience with financial/budget analysis.
• Experience with vendor contract management.
• Experience with business continuity and disaster response planning.

Additional Information:

• Applications must be fully completed; 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 HHSC Human Resources compensation policy.
• Interviews may be conducted online via Microsoft Teams. Applicants should have the ability to meet using virtual meeting tools.
• Selected candidate must be able to work in the Austin office as needed. Out of state applicants will not be considered.

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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.

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.