Job Description

Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 Members with the following programs:

• Medicaid State of Texas Access Reform (STAR) program for low-income children and pregnant women

• Children’s Health Insurance Program (CHIP) for the children of low-income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR

• Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre-existing conditions.

• Community Health Choice (HMO D-SNP), a Medicare Advantage Dual Special Needs plan for people with both Medicare and Medicaid that combines Medicare Part A and Part B benefits, Medicare Part D prescription drug coverage, and Medicaid benefits with additional health benefits like dental, vision, transportation, and more.

Improving Members' experiences is at the heart of every Community position. We strive every day to make sure that our Members have access to the high-quality health care they need and deserve.

Community is accredited by URAC for its health plan operations. We offer care management programs for asthma, diabetes, and high-risk pregnancy. An affiliate of the Harris Health System (Harris Health), Community is financially self-sufficient and receives no financial support from Harris Health or from Harris County taxpayers.

Skills / Requirements

Provides technical services to analyze, design, and deliver clinical/business system and/or application solutions. Developing processes and procedures with in systems to support business stakeholders. Lends expertise to answer technical/application consulting questions, individually or as part of a project team. Serves as a subject matter expert associated with content, processes, and procedures associated with enterprise applications. Responsible for making recommendations regarding policies associated with the job¿s purpose and essential responsibilities.  Routine decisions include those regarding systems implementation and interaction with systems across Community Health Choice systems / applications.


1. Education/Specialized Training/Licensure:

  • Seven (7) years of experience analyzing, designing, and/or delivering clinical/business solutions (a degree maybe offset experience requirement - Bachelor degree = 4 years; Masters degree = additional 2 years)

2. Work Experience (Years and Area):

  • Three (3) years of experience in management of health insurance payor systems.

3. Management Experience (Years and Area): N/A
4. Software Operated: Microsoft Office (Word, Excel, Access, Outlook)

1. Communication Skills:
Above Average Verbal (Heavy Public Contact)
Exceptional Verbal (e.g., Public Speaking)
Writing /Composing: Correspondence / Reports

2. Other Skills: Analytical, Medical Terminology, MS Word, MS Excel, and MS Access
3. Advanced Education:
Bachelor's Degree Major: Computer science, business administration, healthcare administration or other business or technology field.

Master's Degree Major: Computer science, business administration, healthcare administration or other business or technology field.

4. Work Schedule:   Flexible

5. Other Requirements: Knowledge:
Current business practices and computing systems and databases (SQL Server and MS Access).  Proficiency in applying highly technical principals, demonstrated analytical, problem solving and research ability as evidenced by experience in the identification of business requirements and subsequent implementation of appropriate software configuration solutions to business problems.  Knowledge of health insurance payor systems and processes preferred.

Requirements gathering, process mapping, group presentation, written and verbal communication, analytical, and organizational skills. Ability to handle multiple projects simultaneously while adhering to a stringent timeline.   Ability to analyze the functionality of systems and their fit with specifications. 



Application Instructions

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