QSO/UM Coordinator in Austin, TX

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: QSO/UM Coordinator 
Job Title: Program Specialist VII 
Agency: Health & Human Services Comm 
Department: Hospitals Section 
Posting Number: 10418 
Closing Date: 11/19/2025 
Posting Audience: Internal and External 
Occupational Category: Healthcare Practitioners and Technical 
Salary Group: TEXAS-B-25 
Salary Range: $5,797.66 - $9,508.25 
Pay Frequency: Monthly
Shift: Day 
Additional Shift: Days (First) 
Telework:  
Travel: Up to 20% 
Regular/Temporary: Regular 
Full Time/Part Time: Full time 
FLSA Exempt/Non-Exempt: Exempt 
Facility Location:  
Job Location City: AUSTIN 
Job Location Address: 909 W 45TH ST BLDG 552 
Other Locations:  
MOS Codes: 16GX,60C0,611X,612X,63G0,641X,712X,86M0,8U000,OS,OSS,PERS,YN,YNS 
 
 
 

Would you thrive in an environment where you learn and grow personally and professionally all while helping make a positive impact on people's lives? Do you appreciate being around others like yourself who are dependable, trustworthy, hard workers who believe in the value of teamwork? HSCS is dedicated to building an atmosphere where employees feel valued and supported while providing specialized care for Texans in need. HSCS is comprised of nine psychiatric hospitals, one youth residential treatment facility, and thirteen state supported living centers. The psychiatric hospitals are a hub of excellence for forensic mental health and complex psychiatric care, with all facilities accredited by The Joint Commission. They provide state-of-the-art treatment that is recovery-oriented and science-based. If providing hope and healing through compassionate, innovative, and individualized care interests you, we welcome your application for the position below.

The Quality System Oversight (QSO)/Utilization Management (UM) Coordinator (Program Specialist VII) combines the complex functions of quality management and utilization management. These roles are complimentary and require a specific skill set that exercise discretion and independent judgment with regards to the State Hospital System (SHS) QSO and UM programs. The QSO/UM activities impact business operations to a substantial degree and are central to achieving the State Hospital System goal of being centers of excellence by providing person-centered, evidenced-based treatment. The Coordinator performs highly advanced (senior-level) consultative services and expert assistance under the direction of the Governance and Quality Manager. Serves on committees and workgroups of the State Hospital System Governing Body. Works under minimal supervision, with extensive latitude for the use of initiative and independent judgment.

Performs other duties as assigned. Other duties as assigned include actively participating and/or serving in a supporting role to meet the agency's obligations for disaster response and/or recovery or Continuity of Operations (COOP) activation. Such participation may require an alternate shift pattern assignment and/or location.

Essential Job Functions (EJFs):

Attends work on a regular basis and may be asked to work a specific shift schedule or, at times, even a rotating schedule, extended shift and/or overtime in accordance with agency leave policy and performs other duties as assigned.

The Coordinator is responsible for the effective implementation of the SHS QSO and UM programs. Responsibilities include the overseeing and coordination of ten annual external site visits of the state hospitals. The Coordinator is the Contract Manager for the professional external review team to ensure that all contract processes and requirements are met for proper execution and payments. The Coordinator also oversees all aspects of the Utilization Management program with the ten state hospitals, including working closely with Utilization Management staff to monitor current activities. Develops new processes to maximize the use of State resources throughout SHS. Coordinates ongoing reviews and studies with hospital staff that assess and evaluate the care and services provided to individuals receiving treatment. These activities impact business operations to a substantial degree and are central to achieving the State Hospital System goal of being centers of excellence by providing person-centered, evidenced-based treatment.

Carries out major assignments in conducting operations of the programs, including overseeing and managing annual review and updating of the QSO and UM review instruments, applications and processes with the SHS clinical disciplines and state hospital QSO and UM Coordinators to ensure compliance with current Texas Administrative Code) (TAC), Centers for Medicare and Medicaid Services (CMS, and The Joint Commission (TJC) standards.

Manage Institute of Mental Diseases (IMD) program which includes oversight of the program, tracking eligible patients, and reconciling discrepancies, in collaboration with the Reimbursement Department and hospital.

Assesses information from each annual hospital review, prepares and presents reports to leadership to formulate, interpret and implement changes in operating procedures related to the programs. Requests plans of correction as indicated, evaluates the plans of correction, and provides feedback to the hospitals regarding adequacy and any additional actions necessary.

Consults and provides expert advice to SHS clinical staff and leadership regarding compliance with required standards and reconciles disputes or different interpretations. Investigates, researches and resolves policy issues of significance on behalf of leadership.

Oversees the data management and analysis of information collected through these programs and provides reports to SHS leadership regarding trends and recommendations for improvement in the system. Prepares and presents annual reports to the SHS Governing Body identifying system-wide trends and opportunities for improvement to facilitate long- or short-term planning for business objectives.

Participates as a member of the Governing Body Quality Assessment Performance Improvement (QAPI) Committee by providing monthly reports on the QSO program and identifying best practices and system issues that need to be improved. Serves as Vice-Chair of the Utilization Management Subcommittee. Meets and assists the Chair of the UM Subcommittee by ensuing tasks are completed. Prepares a quarterly report to the System Medical Executive Committee (SMEC).

Performs other duties as assigned. Other duties as assigned include but are not limited to actively participating and/or serving in a supporting role to meet the agency's obligations for disaster response and/or recovery or Continuity of Operations (COOP) activation. Such participation may require an alternate shift pattern assignment and/or location.

Knowledge, Skills and Abilities (KSAs):

Knowledge and experience with quality management and utilization management principles, psychiatric hospital operations, and clinical care.

Knowledge and experience with MS Office including WORD, EXCEL, and PowerPoint.

Knowledge of laws and rules applicable to confidentiality and management of protected health information. Knowledge of SharePoint.

Basic knowledge of data collection and aggregation and data analysis.

Advanced knowledge of medical/clinical/behavioral health processes in an inpatient setting.

Knowledge of local, state, and federal laws related to the program area. Knowledge of public administration and management techniques.

Knowledge of statistical analysis processes. Knowledge of research techniques.

Excellent verbal communication skills with all levels of staff, data management skills to administer comprehensive and complex data bases, and analytical skills.

Skills in the preparation and presenting of complex information and reports.

Skill in providing training to staff regarding the QSO program and providing technical assistance for program implementation.

Skill in identifying measures or indicators of program performance and in operating computers and applicable software.

Exceptional verbal and written communication skills.

Ability to work with the QSO and UM software and communicate functional needs to the programmer.

Ability to work with multiple hospital staff members at various levels of the organization.

Ability to work in collaboration with others to manage multiple deadlines. Ability and experience to create and implement new training materials for new initiatives.

Ability and experience managing various types of committees.

Ability to gather, assemble, correlate, and analyze facts and devise solutions to problems. Ability to oversee programs.

Ability to prepare reports.

Ability to develop, evaluate, and interpret policies and procedures. Ability to train, lead, assign, and/or prioritize the work of others.

Registrations, Licensure Requirements or Certifications:

Certified Texas Contract Manager (CTCM) certification or have the ability to obtain CTCM certification in the first six months of employment.

Initial Screening Criteria:

Experience in a field related to the agency program. Graduation from an accredited four-year college or university with major coursework in a field relevant to the assignment is generally preferred. Experience and education may be substituted for one another.

Additional Information:

Applicants must pass a fingerprint criminal background check, pre-employment drug screen, and registry checks including the Client Abuse/Neglect Reporting System (CANRS), Nurse Aid, Medication Aide and Employee Misconduct, List of Excluded Individuals/Entities (LEIE). Males between the ages of 18-25 must be registered with the Selective Service.

All applicants must be at least 18 years of age to be considered for employment at a state-operated facility. Waco Center for Youth applicants must be 21 years of age.

Flexibility in work hours may be required for this position. The position may be required to work overtime and/or extended hours.

Compliance with HHSC immunization policy and state hospital operating procedures related to immunizations is required. According to the Centers for Disease Control and Prevention, healthcare workers are considered to be at significant risk for acquiring or transmitting hepatitis B, measles, mumps, rubella, varicella (chicken pox), tetanus, diphtheria, pertussis (whooping cough), and influenza. All these diseases are vaccine preventable. As a result, state hospital policy requires employees be vaccinated according to their level of contact with individuals. In the event you choose to not be immunized for the influenza virus, you may be required to wear a mask and take other protective measures.

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.