Job Closed
This listing is no longer active.
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.
QMU Manager
Location
United States
Posted
106 days ago
Salary
$7.0K - $11.9K / month
Seniority
Lead
No structured requirement data.
Job Description
QMU Manager
TX-HHSC-DSHS-DFPS
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: QMU Manager Job Title: Manager VI Agency: Health & Human Services Comm Department: QMP Nurses and Pharm RMS FTE Posting Number: 14620 Closing Date: 03/26/2026 Posting Audience: Internal and External Occupational Category: Healthcare Practitioners and Technical Salary Range: $7,015.16 - $11,864.50 Pay Frequency: Monthly Salary Group: TEXAS-B-27 Shift: Day Additional Shift: Telework: Eligible for Telework Travel: Up to 30% Regular/Temporary: Regular Full Time/Part Time: Full time FLSA Exempt/Non-Exempt: Exempt Facility Location: Job Location City: AUSTIN Job Location Address: 7701 METROPOLIS DR 100 Other Locations: MOS Codes: 0203,0207,0302,0520,0602,0802,1802,5502,6302,6502,7202,7208,7210,7220,111X,112X,113X,114X,16GX,41AX 611X,612X,631X,632X,641X,648X,86M0,86P0,8U000,9G100,SEI15 The Texas Health and Human Services Commission (HHSC) Medicaid CHIP Services (MCS) division seeks a highly qualified candidate to fill the position of Quality Monitoring Unit (QMU) Manager VI in the Quality Monitoring Program (QMP). 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 performing highly advanced managerial work, leadership, direction, guidance, and daily operations of QMP. QMP helps address conditions in Texas nursing facilities (NFs) that could be detrimental to the health, safety and welfare of residents. QMP is not a regulatory program and the QMU staff do not cite deficient practices. QMU prioritizes visits to NFs that have a history of resident care deficiencies, or that have been identified as having a higher-than-average risk of being cited for significant deficiencies in future surveys conducted by the HHSC Long-Term Care Regulation staff. 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 QMU Manager VI performs highly advanced (senior-level) managerial work administering the daily operations and activities of the QMU. The QMU Manager VI works under minimal supervision, with extensive latitude for the use of initiative and independent judgment. The QMU Manager VI establishes QMU goals and objectives and develops guidelines, procedures, and policies. The QMU Manager VI develops staff schedules, priorities, and standards to achieve department goals, objectives, and functions. The QMU Manager VI is responsible for developing, evaluating, and monitoring QMU budget expenditures. The QMU Manager VI position serves as a back-up to the QMP Director. Essential Job Functions: This position manages multiple business functions and provides oversight to associated staff. The QMU Manager VI evaluates travel expenditures of staff daily to ensure alignment with current budgetary requirements, policies, and procedures. The QMU Manager VI reviews and approves budget requests weekly. The QMU Manager VI implements budget adjustments and operational changes as needed to ensure QMU operates within established budgets. The QMU Manager VI identifies business functions in need of changes and makes recommendations to the department leadership, which includes the Deputy Associate Commissioner, Director III, and Program Managers to improve QMP operations. 35% The QMU Manager VI serves as the back-up to the QMP Director III. This position reviews and evaluates the impact of proposed federal and state laws on program objectives. This position oversees the implementation of changes resulting from new legislation. The QMU Manager VI prepares and presents qualitative and quantitative productivity reports quarterly to QMP Director III and Deputy Associate Commissioner. 35% The QMU Manager VI manages the day-to-day activities of the QMU in the Quality Monitoring Program (QMP). Provides professional oversight and guidance to QMU staff, including management and professional level staff, to ensure compliance with the policies and procedures of the program and agency. The QMU Manager VI provides technical expertise and guidance for the recruitment, hiring, and training of all QMU staff. The QMU Manager VI completes performance evaluations, offers coaching and discipline, terminations, and separations for direct reports. The QMU Manager VI ensures direct reports complete required trainings to be in compliance with policies of the program and agency. The QMU Manager VI oversees staff development plans, productivity, and performance. The QMU Manager VI develops and approves staff schedules. 20% The QMU Manager VI oversees special projects and the implementation of special initiatives. The QMU Manager VI develops, reviews, updates, implements, and monitors compliance program policies and procedures, rules, and regulations using a systematic approach in evaluating QMU functions and activities. The QMU Manager VI identifies and provides input in the development of evidence-based best practices for staff to present and work with nursing facilities. 10% Registrations, Licensure Requirements or Certifications: - Unencumbered Registered Nurse or Registered Pharmacist - This position may require use of a personal motor vehicle to complete job functions. This position requires a reliable motor vehicle, a current, valid Texas driver's license and valid insurance. Applicants must provide proof of insurance and license. Initial Screening Criteria: - Experience with Nursing Facility rules and regulations and monitoring practices. - Experience in best practices for Nursing Facilities. - Excellent written communication as observed by detail and completeness of information provided on the state application. - Is an unencumbered Registered Nurse or Registered Pharmacist. Knowledge Skills Abilities: - Knowledge of HHSC policies and procedures. - Knowledge of federal and state regulations for nursing facilities. - Knowledge of principles of nursing, nutrition and/or pharmacy practices especially as related to the geriatric population. - Knowledge of senior level management principles and strategic planning techniques, including analysis, planning, measurement, and achievement of established goals. - Skill in managing multiple priorities without jeopardizing deadlines or systems. - Skill in presenting complex concepts and information. - Skill in collecting and analyzing complex data, evaluating information, and drawing logical conclusions and providing results in a report format. - Ability to manage program activities. - Ability to establish, implement, and evaluate program goals and objectives. - Ability to devise solutions to administrative and personnel issues. - Ability to prepare and implement performance plans and conduct evaluations. - Ability to plan, assign, and supervise the work of regional staff. - Ability to communicate effectively both orally and in writing. - Ability to consistently meet deadlines in a timely and reasonable manner. - Ability to work with and maintain confidential records, files, and information. - Must be able to travel up to 30% of the time. Additional Information: Information on application must clearly state how applicant meets initial selection criteria in the summary of experience section of the application. Resumes will not be accepted in lieu of an application. Agency salary policy, budget, and candidate’s qualifications will dictate final salary offer. 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.
Related Guides
Related Categories
Related Job Pages
More Manager Jobs
Modified Adjustment Gross Income Rules Engine Supervisor (PSA, Opt. 1)
State of IllinoisThe State of Illinois, otherwise known as the "Prairie State," was the 21st territory inducted into the United States in 1818. The state name derives from a Nat
Job Requisition ID: 54191 Opening Date: 03/12/2026 Closing Date: 03/26/2026 Agency:Department of Healthcare and Family Services BPIS: 10193 Class Title: PUBLIC SERVICE ADMINISTRATOR - 37015 Skill Option: General Administration/Business Marketing/Labor/Personnel Bilingual Option: None Salary: Anticipated starting salary $8500 - $10,500/monthly Job Type: Salaried Category: Full Time County: Sangamon Number of Vacancies: 1 Bargaining Unit Code: None Merit Comp Code: Gubernatorial (Management Bill) Exclusion from RC063 Collective Bargaining Coverage A resume is highly encouraged to evaluate your qualifications and skills as part of your application. Please attach a DETAILED Resume/Curriculum Vitae (CV) to the MY DOCUMENTS section of your application if you decide to provide one. Why Work for Illinois? Working with the State of Illinois is a testament to the values of compassion, equity, and dedication that define our state. Whether you’re helping to improve schools, protect our natural resources, or support families in need, you’re part of something bigger—something that touches the lives of every person who calls Illinois home. No matter what state career you’re looking for, we offer jobs that fit your life and your schedule—flexible jobs that provide the gold standard of benefits. Our employees can take advantage of various avenues to advance their careers and realize their dreams. Our top-tier benefits and great retirement packages can help you build a rewarding career and lasting future with the State of Illinois. Position overview: The Department of Healthcare and Family Services, Bureau of Eligibility Integrity is seeking to hire a manager to oversee a team of Information System Analysts and Management Operations Analyst. As the MAGI Rules Administrator, you will work with a large team of colleagues in HFS and in other state agencies to improve the lives of Illinoisians by assuring that HFS Programs provide accurate health benefits coverage to eligible Illinoisians consistent with State and Federal requirements. You will become a part of a team committed to providing health benefits to maximize the health and well-being of our customers, with consistent and responsive customer service, and based on a foundation of equity for all customers. The ideal candidate must have a knowledge/experience of rules engine logic in a public means benefit system, understanding of relational databases, and creating complex SQL queries with knowledge of State and Federal Medicaid laws. The ideal candidate must be a proven leader, strong researcher, and have proven experience with SQL logic in a relational database. The ideal candidate will be able to demonstrate the ability to present data to explain complex medical policy in ways that are easy to understand for a variety of audiences. The nature of the work is very collaborative and requires good working relationships with other staff and bureaus in HFS, other agencies, and contactors. This position is a fast-paced environment requiring flexibilities, excellent prioritization skills and dedication to teamwork. HFS values employees with different backgrounds, life experiences, and talents. Employees receive a robust benefit package including: • Monday-Friday work schedule • Flexible work schedules are available in many program areas. (Remote work may be an option for certain positions.) • Health, Life, Vision, and Dental Insurance • Pension Plan • Paid Parental Leave • Deferred Compensation Program and other pre-tax benefit programs (Medical/Daycare) • Employees earn (12) paid Sick Days annually. • New Employees earn (10) paid Vacation Days their first year of service and can earn up to (25) paid Vacation Days annually. • Employees earn (3) paid Personal Days annually. • (13-14) paid holidays annually (based on start date) If you are seeking a new opportunity, and this position appeals to you, please apply today! At the Illinois Department of Healthcare and Family Services (HFS), we value staff as our greatest asset. We work in a spirit of teamwork to help millions of Illinoisans access high quality healthcare and fulfill child support obligations to advance their physical, mental, and financial well-being. We provide healthcare coverage for children and adults through Medicaid and other medical programs, and we help ensure that children receive financial resources from both their parents through Child Support Services. The HFS Office of the Inspector General investigates, audits and reviews program activity to ensure the integrity of our programs is maintained. HFS is committed to promoting and preserving a workplace culture that embraces diversity, equity, and inclusion. We welcome and value employees with different backgrounds, life experiences, and talents. It is the collective sum of our individual differences that provides a broad perspective, leading to greater innovation and achievement. In recruiting for our team, we recognize the unique contributions of each applicant regardless of culture, ethnicity, race, national origin, sex, gender identity and expression, age, religion, disability, and sexual orientation. HFS is an equal opportunity employer. Essential Functions - Subject to management approval, serves as the Modified Adjustment Gross Income (MAGI) Rules Engine Supervisor in planning, directing and evaluating the statewide Non-MAGI Rules Engine Program - Serves as a full line supervisor - Directs and implements the development of rules engine logic deployed to the rules engine for the accurate processing of medical eligibility decisions - As Rules Engine Specialist, attends meetings to present complex research findings and answer technical questions - Monitors program functions to ensure compliance with Department guidelines and other State or Federal rules and regulations involving eligibility - Performs other duties as required or assigned which are reasonably within the scope of the duties enumerated above Minimum Qualifications - Requires knowledge, skill and mental development equivalent to completion of four (4) years of college - Requires prior experience equivalent to three (3) years of progressively responsible administrative experience in a public or business organization Preferred Qualifications - Three (3) years of professional experience interpreting and analyzing Federal and State Medicaid and child health insurance laws - Three (3) years of experience working with database management systems for automated decision making comparable to Medical eligibility systems and experience applying rules engine logic to implement medical programs eligibility policy - Three (3) years of professional experience analyzing large sets of data in comparison to administrative programs and adopting and effective course of action for a public or private organization, State or Federal agency - Three (3) years of professional experience developing, installing, and evaluating new and revised methods, procedures, and performance standard to meet Federal and State guidelines - Three (3) years of professional experience exercising judgement and discretion in developing, implementing, and interpreting organizational policies and procedures for a public or private organization, State or Federal agency - Three (3) years of professional supervisory experience working with labor and employment development, including staff utilization and employee motivation - Three (3) years of professional experience in Medicaid eligibility specifically administrative experience developing data abstracts with SQL software in regard to a relational database Conditions of Employment - Requires completion of a background check and self-disclosure of criminal history - Requires the ability to travel in the performance of duties, with overnight stays as appropriate - Requires the ability to utilize and maintain state issued equipment such as a laptop and/or cell phone - Overtime is a condition of employment, and you may be requested or required/mandated to work overtime including scheduled, unscheduled, or last-minute overtime. This requires the ability to work evenings and weekends - The conditions of employment listed here are incorporated and related to any of the job duties as listed in the job description Work Hours: Monday - Friday 8:30 a.m - 5:00 p.m. Headquarter Location: 201 S Grand Ave E, Springfield, Illinois, 62704 Work County: Sangamon Email: HFS.DMPApps@illinois.gov Posting Group: Leadership & Management The main form of communication will be through email. Please check your “junk mail”, “spam”, or “other” folder for communication(s) regarding any submitted application(s). You may receive emails from the following addresses: - donotreply@SIL-P1.ns2cloud.com - systems@SIL-P1.ns2cloud.com
• Manages all Fleet & Safety related activities • Manages the relationship and business performance requirements of 3rd Party Fleet Service Providers • Leads the coordination of fleet delivery schedules with Fleet Suppliers (U.S. & Canada) • Produces complex financial comparative analysis and financial considerations of life cycle management for the Fleet • Manages the Order Cycle for Fleet and Replacement Schedule • Establishes Policy and Procedure requirements for the user community that will be assigned fleet vehicles • Resolves and Troubleshoots issues that arise between government entities and Users of the Fleet
Payment Accuracy Manager, Outpatient Facility
RialticWe are on a mission to make healthcare more efficient.
• Serve as the SME for outpatient facility editing policy development, leading the research, scoping, and creation of new claims editing policies for the facility capability • Source, interpret, and scope new payment integrity policies to expand Rialtic's claims editing content library from outpatient facility claims • Prioritize policy updates based on savings potential, client impact, and strategic alignment with platform goals • Leverage CMS, Medicaid, clinical guidelines, and industry trends to identify opportunities for new content development for facility claims • Quantify and communicate policy value through data-driven analysis and clear financial impact assessments in the facility space • Work closely with product and engineering teams to ensure client needs inform platform development, building out our facility capability • Collaborate with content leadership to maintain consistency, quality, and relevance across the policy library • Perform investigation of current facility policy defects and unexpected claim outcomes, performing root cause analysis and policy research to identify corrective actions and improve policy accuracy and performance • Serve as the facility payment accuracy SME in client discussions, presenting policy concepts and addressing facility-related questions when needed
• Own portfolio-level yield strategy including floor policies, rate card guidance, discount bands, alerting, and prioritization rules across Precision and Core Programmatic channels • Design inventory and PMP packaging frameworks (audience, venue, daypart, exclusivity) and define end-to-end programmatic deal operations from setup through optimization • Run structured experiments (A/B, multivariate) on pricing, floors, and priority rules; build forecasting models quantifying revenue and margin impact • Partner with Analytics to build unified dashboards across channels; establish campaign health standards and serve as escalation point alerts for systemic issues • Lead strategic SSP partner management including QBRs, roadmap discussions, and monetization opportunities; collaborate with Ad Tech on server/OMS configurations • Collaborate with Ad Operations, Sales, Pricing, Product and Data teams


