Medicaid Program Integrity Jobs in Texas (NOW HIRING)

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Job Description
The Executive Director - School Health and Related Services Program Accountant - Accounting & Finance serves as HISD's lead finance/accounting operator for its SHARS Program, a Texas-administered Medicaid program operating under federal Medicaid law. This is a senior-level accounting and compliance position responsible for fiscal oversight, revenue maximization, internal controls, and regulatory compliance for all SHARS reimbursement activities. The position ensures full compliance with Texas Health and Human Services Commission (HHSC) rules, Texas Medicaid & Healthcare Partnership (TMHP) billing requirements, Texas Education Agency (TEA) guidance, HISD policies, and applicable federal Medicaid regulations, while safeguarding district financial integrity and audit readiness.
Responsibilities
Executive Director - SHARS Program Accountant (Finance & Accounting) - Responsibilities body { font-family: Arial, sans-serif; font-size: 14px; color: #333; margin: 16px; } .section-label { font-weight: bold; font-size: 14px; margin-bottom: 16px; } ol { margin-top: 0; padding-left: 24px; } li { margin-bottom: 4px; line-height: 1.5; }
Responsibilities

1. Executive Leadership & Program Governance
2. Serve as the district's executive authority for the SHARS program, providing strategic direction, fiscal governance, and long-term sustainability planning.
3. Advise the CFOO/Controller on SHARS revenue, risk exposure, audit findings, and compliance matters.
4. Fiscal Management & Accounting Oversight
5. Direct all accounting functions related to SHARS revenues, including:
6. Revenue recognition and reconciliation
7. Maintenance of SHARS-specific general ledger accounts
8. Cash receipts, accruals, and adjustments
9. Ensure SHARS revenues are recorded in accordance with HISD standards and financial policies.
10. Prepare and present monthly financial reports detailing SHARS revenue performance, trends, and projections.
11. SHARS Billing & TMHP Claims Administration
12. Oversee the end-to-end SHARS billing cycle in TMHP, ensuring:
13. Accurate submission of claims for eligible SHARS services
14. Timely correction and resubmission of denied or adjusted claims
15. Compliance with TMHP billing manuals, policy updates, and deadlines
16. Establish internal controls to ensure that claims are supported by valid IEPs, provider credentials, and compliant service documentation.
17. State/Federal Compliance and Audit Monitoring
18. Ensure HISD compliance with:
19. Texas Administrative Code related to SHARS
20. HHSC and TMHP SHARS policy manuals
21. Federal Medicaid requirements applicable to school-based services
22. Lead preparation for and response to:
23. TMHP reviews
24. HHSC or TEA monitoring
25. State and federal audits
26. Develop and maintain corrective action plans when required and ensure timely resolution of findings.
27. Coordinate PEIMS/finance alignment and other cross-functional reporting dependencies with district teams as needed.
28. Documentation, Internal Controls & Risk Management
29. Establish and enforce districtwide policies and procedures governing:
30. SHARS documentation standards
31. Provider credential verification
32. Time studies (if applicable)
33. Record retention requirements
34. Conduct periodic internal reviews to identify compliance risks and implement corrective measures.
35. Data Analysis & Revenue Optimization
36. Analyze SHARS data to monitor:
37. Claim acceptance and denial rates
38. Provider productivity
39. Revenue trends by service type
40. Use data to improve billing accuracy, strengthen compliance, and maximize allowable SHARS reimbursement.
41. Interagency Coordination and Communication
42. Serve as HISD's primary liaison with:
43. Texas Medicaid & Healthcare Partnership (TMHP)
44. Texas Health and Human Services Commission (HHSC)
45. Education Service Centers (ESCs)
46. External auditors and consultants
47. Oversee SHARS vendor contracts, monitor performance, and ensure contract compliance.
48. Other duties as assigned.

Qualifications
Executive Director - SHARS Program Accountant (Finance & Accounting) - Skills body { font-family: Arial, sans-serif; font-size: 14px; color: #333; margin: 16px; } .section-label { font-weight: bold; font-size: 14px; margin-bottom: 16px; } p { margin: 4px 0 10px 0; }
Job Qualifications
EDUCATION
Bachelor's degree in accounting, finance, or related field Master's Degree Preferred Active CPA Preferred
WORK EXPERIENCE
7+ years progressive accounting/finance experience, including: Medicaid program administration Internal controls and audit support Budgeting/forecasting and variance analysis Experience in public sector / school district finance (Texas preferred).
TYPE OF SKILL AND/OR REQUIRED LICENSING/CERTIFICATION
Software Oracle SAP Microsoft Office Certifications/Licensure Certified Public Accountant (CPA) Equipment Office equipment (e.g., computer, copier) Deep knowledge of GAAP-based accounting operations, internal controls, and audit standards. Strong command of budgeting, forecasting, and executive financial storytelling Knowledge of TEA, FASRG, and GASB/FASB compliance Ability to operate in a high-accountability environment with multiple stakeholders and time-sensitive deliverables. High discretion, strong judgment, and ability to escalate issues with clear recommendations. Strong strategic thinking and analytical skills, with the ability to translate vision into actionable plans. Demonstrated track record of successfully leading and managing teams, fostering a high-performance culture. Excellent communication and interpersonal skills, with the ability to effectively engage and influence stakeholders at all levels. Strong financial acumen, with experience in budget planning, financial management, and resource allocation. Proven ability to develop and implement strategic initiatives that drive organizational growth and impact. Exceptional problem-solving and decision-making abilities, with the capacity to navigate complex challenges. Demonstrated ability to build and maintain positive relationships with internal and external stakeholders. Strong project management skills, with the ability to manage multiple priorities and meet deadlines. Knowledge of relevant industry regulations, compliance standards, and best practices. Ability to adapt to change and lead teams through organizational transitions. Commitment to diversity, equity, and inclusion principles and practices. Strong ethical standards and integrity in decision-making. Professional certifications or memberships relevant to the industry or leadership role are desirable.
LEADERSHIP RESPONSIBILITIES
Directs two or more levels of management in the development, deployment and ongoing management of key initiatives covering multiple major disciplines with direct accountability for results in terms of effectiveness, costs, methods, and employees. Establishes operational objectives and assignments for multiple disciplines/functional areas and possibly departments. Evaluates recommendations of others, deciding on course of action in ambiguous situations, and oversee the deployment of innovative solutions. Collaborates with senior leadership to develop strategies and broad departmental objectives; establishes methods, techniques and evaluation criteria for projects, programs, and people in the achievement of strategic objectives.
WORK COMPLEXITY/INDEPENDENT JUDGMENT
Work is non-standardized and widely varied, involving many complex and significant variables including significant time spent planning, evaluating complex solutions and issues, and negotiating outcomes. Strong analytic ability and inductive thinking are frequently required to devise new approaches to situations where previously accepted solutions have proven inadequate. Position regularly makes recommendations to management on areas of significance to the division. Supervision received typically consists of providing periodic coaching, advice, and feedback.
BUDGET AUTHORITY
Compiles and organizes data and figures. Analyzes and interprets data and figures. Specifies requirements for a plan and/or budget. Participates in a group plan and/or budget development. Approves budgets.
PROBLEM SOLVING
Decisions are made with greater freedom and discretion, including recommendations that are subject to approval on matters that may affect multiple departments across HISD. Job is frequently expected to recommend new solutions to problems, to improve existing methods/procedures/services and generate new ideas. May also review decisions made by other individuals on more routine matters.
IMPACT OF DECISIONS
Decisions have considerable impact to multiple divisions or the organization causing risks or improvements to relationships, significant efficiencies, or delays in operations, and/or significant financial gains or expenses. Errors are serious and difficult to discover, normally involve decisions not subject to detailed review and will result in excessive costs and/or significant project delays.
COMMUNICATION/INTERACTIONS
Negotiate and influence - interpret department strategies and services, resolves conflicts, influences outcomes on matters of significance for the division, conducts final negotiations and coordinates approvals/decision making below the executive level. Interactions are typically with customers and Top Management.
CUSTOMER RELATIONSHIPS
Regularly assesses and diffuses complex and escalate customer issues. Takes personal responsibility and accountability for solving systemic customer service problems. Regularly explores alternative and creative solutions to meeting the needs of the customer within HISD's policies and guidelines.
WORKING/ENVIRONMENTAL CONDITIONS
Work is normally performed in a typical interior work environment which does not subject the employee to any hazardous or unpleasant elements.