Director of Rural Hospital Finance

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: Director of Rural Hospital Finance

Job Title: Director IV

Agency: Health & Human Services Comm

Department: HHS Provider Finance SHARS

Posting Number: 20606

Closing Date: 10/24/2026

Posting Audience: Internal and External

Occupational Category: Business and Financial Operations

Salary Range: $8,488.33 - $14,356.00

Pay Frequency: Monthly

Salary Group: TEXAS-B-29

Shift: Day

Additional Shift:

Telework: Eligible for Telework

Travel: Up to 15%

Regular/Temporary: Regular

Full Time/Part Time: Full time

FLSA Exempt/Non-Exempt: Exempt

Facility Location:

Job Location City: AUSTIN

Job Location Address: 4601 W GUADALUPE ST

Other Locations:

MOS Codes: 8003,8040,8041,8042,10C0,111X,112X,113X,114X,20C0,30C0,40C0,611X,612X,631X,641X,648X,90G0,91C0,91W0

97E0,SEI15

Brief Job Description:

Do you want to help rural hospitals keep care closer to home for Texans? The Office of Rural Hospital Finance is looking for a leader who can build strong relationships, solve practical problems, and guide a team that helps rural hospitals navigate HHSC programs, access technical assistance, and use grant funding to support financial stability, innovation, pediatric tele-connectivity, and emergency needs. This position leads highly advanced managerial work for the Office of Rural Hospital Finance, including strategic planning, stakeholder communication, program coordination, grant operations, policy implementation, budget oversight, and supervision of staff. Works under minimal supervision, with extensive latitude for initiative and independent judgment.

Essential Job Functions (EJFs):

Directs Office of Rural Hospital Finance program activities and business functions, including technical assistance, stakeholder support, internal coordination, and grant program operations. 20%

Serves as a senior point of contact and internal navigator for rural hospital issues across HHSC and the Texas Health and Human Services system, including coordination with DSHS and other program areas as needed. 20%

Oversees development and implementation of stakeholder education, communications strategies, awareness campaigns, and customer service support for rural hospitals. 15%

Directs or supports rural hospital initiatives, including Rural Emergency Hospital designation activities, process and form review, Medicaid supplemental and directed payment program assistance, and analysis of participation barriers. 15%

Coordinates the Rural Hospital Advisory Committee and leads development, biennial updates, progress reporting, goals, and strategies for the Rural Hospital Services Strategic Plan. 10%

Oversees grant funding activities for rural hospitals, including financial stability, innovation, pediatric teleconnectivity, emergency hardship funding, and related budget, reporting, and compliance activities. 10%

Provides professional oversight and guidance to management, professional, and support staff and performs related work as assigned. 10%

Knowledge, Skills and Abilities (KSAs):

Knowledge of local, state, and federal laws, regulations, funding structures, and policy issues relevant to rural hospitals, Medicaid, health care finance, grant programs, public-sector program administration, and health and human services operations.

Knowledge of public administration and management principles, including strategic planning, stakeholder engagement, resource allocation, budgeting, performance measurement, communications, policy implementation, change management, and leadership of a department or major program area.

Knowledge of rural hospital operations, provider finance, Medicaid supplemental and directed payment programs, grant administration, technical assistance models, customer service strategies, and methods for identifying and addressing barriers to program participation.

Knowledge of supervisory and management practices, including second-level supervision, staff development, delegation, accountability systems, performance management, and coordination of multidisciplinary teams.

Skill in building and sustaining collaborative relationships with rural hospitals, agency staff, state partners, advisory committees, executive leadership, program areas, and other internal and external stakeholders.

Skill in exercising good judgment, analyzing complex issues, weighing risks and alternatives, making sound recommendations, and leading decisions that support program goals, fiscal responsibility, and effective public service.

Skill in strategic planning, problem solving, process improvement, budget review, grant oversight, written and verbal communication, stakeholder education, customer service, and use of applicable technology and software.

Ability to lead a department or major program area, establish direction, set priorities, align resources, monitor performance, and ensure work is completed accurately, timely, and in accordance with program goals and agency requirements.

Ability to provide second-level supervision by directing managers or supervisors, guiding team operations, supporting staff development, resolving escalated issues, and promoting accountability, collaboration, and effective communication across the team.

Ability to direct and organize program activities, grant operations, technical assistance, stakeholder communications, advisory committee coordination, strategic planning, reporting, and business functions.

Ability to communicate complex program, policy, grant, and finance information clearly to varied audiences, including rural hospitals, executive leadership, agency staff, advisory committees, legislators, and other stakeholders.

Ability to develop and evaluate policies, procedures, goals, standards, budgets, performance measures, reports, strategic plans, and process improvements that support rural hospital access, financial stability, and program compliance.

Registrations, Licensure Requirements or Certifications:

N/A

Initial Screening Criteria:

Required:

Graduation from an accredited four-year college or university with a bachelors degree.

A minimum of three years' experience managing or directing complex programs, business functions, operations, budgets, and staff.

Relevant experience may be substituted for the required education on a year-for-year basis.

Preferred:

Experience managing Medicaid, health care finance, rural health, hospital finance, reimbursement, grant, or public-sector programs.

Experience providing technical assistance, customer service, stakeholder coordination, or communications support to health care providers or external partners.

Experience developing strategic plans, goals, policies, procedures, standards, performance measures, reports, or process improvements.

Experience managing budgets, grant funding, resource allocation, staffing, organizational change, or program implementation.

Experience coordinating advisory committees, workgroups, legislative inquiries, appropriation requests, or executive-level briefings.

Experience supervising managers, professional staff, or multidisciplinary teams.

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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 Auditors 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.