Program Manager

The Program Manager, Quality Assurance, is responsible for leading and overseeing quality assurance operations related to outpatient Substance Use Disorder (SUD) treatment programs regulated by the Health and Human Services Commission (HHSC). This position manages a team of Audit Coordinators responsible for conducting compliance audits, monitoring departmental performance, and ensuring adherence to federal, state, contractual, and HHSC requirements.

The Program Manager provides strategic direction, supervision, and technical guidance to audit staff; develops and implements quality assurance initiatives; analyzes audit findings and trends; and collaborates with program leadership to drive continuous quality improvement. The position serves as a subject matter expert on regulatory compliance and performance monitoring, ensuring that outpatient SUD programs maintain high standards of service delivery and regulatory compliance.

Key responsibilities include overseeing audit planning and execution, reviewing audit results and performance improvement plans, identifying systemic compliance risks, developing policies and procedures, monitoring quality metrics, and preparing reports and presentations for executive leadership and regulatory agencies. The Program Manager fosters a culture of accountability, compliance, and continuous improvement while supporting organizational goals and ensuring readiness for HHSC audits, reviews, and inspections.

This position requires strong leadership, analytical, and communication skills, as well as extensive knowledge of behavioral health regulations, quality management principles, and auditing practices related to outpatient SUD treatment services.

• Manage the planning, scheduling, and conducting of full‑scope and targeted audits of SUD and related programs to verify compliance with HHSC regulations, contractual SOWs, and TAC requirements.

• Validate service delivery against contractually required service levels, client/participant satisfaction, service capacity, access to services, populations served, evidence‑based practices, and timeframes.

• Manage auditors to ensure the completeness of on‑site visits across Texas to observe operations, perform data integrity checks across EHR/EMR systems, conduct facility walkthroughs, and evaluate environment of care.

• Oversee the production of clear, timely audit reports detailing scope, findings, ratings, and risk prioritization.

• Collaborate with providers to oversee the development of Performance Improvement Plans (PIPs).

• Present audit findings to providers, leadership, and network provider partners.

• Partner with provider network to align on standards and remediation.

• Lead, mentor, and develop team of auditors by providing technical oversight, facilitating knowledge transfer, and promoting consistent application of audit standards and regulatory requirements.
• Perform all other duties as assigned.

The position may require travel within the state of Texas.

Education: Bachelors degree; experience may be substituted in lieu of degree.

Preferred Experience: Experience working within Quality Assurance and auditing. Relevant experience and knowledge working with substance use care and mental health support.

• Regulatory Acumen: Interprets and operationalizes HHSC requirements, SOWs, and TAC standards.

• Audit Rigor: Applies structured methodologies, risk‑based sampling, and objective scoring.

• Data‑Driven: Converts metrics into insights; monitors PIP effectiveness.

• Communication & Influence: Writes crisp reports; presents to diverse audiences; builds provider buy‑in.

• Field Readiness: Manages extensive travel; adapts to varied provider settings statewide.

• Integrity & Judgment: Handles sensitive information; exercises impartial, evidence‑based decision‑making.

• Continuous Improvement: Identifies system gaps; recommends pragmatic, sustainable fixes.