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About the Role

The Reimbursement Analyst I position performs highly complex (senior-level) rate analysis work of reimbursement payment rates and pricing for the Provider Finance Department. This role involves developing and implementing data analysis to determine and evaluate payment rates, preparing cost surveys, and presenting recommendations and reports. The position offers considerable latitude for initiative and independent judgment.

Responsibilities

Manage the payment rate development process, including independent research and gathering information from multiple data sources.
Conduct complex data analysis to determine and evaluate Medicaid and other payment rates.
Summarize analysis and findings in concise documentation.
Conduct and/or participate in public rate hearings.
Provide timely responses to questions from providers and the public.
Develop, modify, and maintain complex computer programs, spreadsheets, and large databases used in payment rate analysis.
Develop reimbursement policy guidelines, agency rules, state plan amendments, and other associated documents relating to cost reporting and payment rate determination.
Work with team members and manager to develop and implement complex data analysis to determine payment rates for various Medicaid and non-Medicaid programs.
Design and conduct special cost and statistical research and analysis to evaluate the feasibility and cost implications of payment rate structure options, new program initiatives or enhancements, special payment rate initiatives, and new regulations.
Utilize Microsoft Excel proficiently.
Communicate complex information to internal and external parties to provide, exchange, or verify information, answer inquiries, address issues, or resolve problems or complaints.
Interface with various contracted providers, provider representatives, client advocates, other agency staff, advisory committees, workgroups, attorneys, and other interested parties concerning payment rate methodology issues affecting program delivery and payment rate determination.
Record and summarize all forms of public testimony regarding proposed rates.
Respond to inquiries and questions from providers, stakeholders, or internal staff.
Provide information to answer questions, and may complete or contribute to legislative analysis, open records requests, or other items as needed.
Verify the accuracy of contractor implementation of approved rates.
Develop and process reimbursement aspects of policy documents, including policy guidelines, agency rules, state plan amendments, council and advisory committee items, workgroup materials, and hearing notices relating to payment rate and payment methodology determination.
Perform other work as assigned or required to maintain and support the office and HHSC operations.

Requirements

Knowledge of health and human service programs, services, and procedures.
Knowledge of accounting, business, and management principles, practices, and procedures.
Knowledge of state and federal laws and regulations relating to Medicaid reimbursement and public administration.
Knowledge of reimbursement methods and payment fees, formulas, and procedures.
Skill in the development, implementation, and application of reimbursement methodologies and payment rates.
Skill in interpersonal relationships and in establishing and maintaining effective working relationships.
Skill in analyzing laws, regulations, program policies, and issues.
Skill in using personal computers and word processing, spreadsheet, statistical, and other software to develop payment rates.
Skill in using complex formulas in spreadsheet software.
Skill in preparing well-written briefing documents and reports designed to convey complex detailed concepts.
Skill in managing multiple projects with competing deadlines.
Ability to develop, evaluate, implement, and interpret policies, procedures, and rules.
Ability to exercise independent judgment, set priorities, meet deadlines, and adapt to shifting technical and political developments.
Ability to manage projects effectively and produce quality work within short deadlines.
Ability to communicate effectively both orally and in writing with a variety of agency staff, medical/provider associations, client advocates, legislative staff, lawyers, state/federal auditors, and interested parties on Medicaid reimbursement issues.

Skills

Data analysis
Rate analysis
Cost surveys
Report preparation
Medicaid reimbursement
Public administration
Reimbursement methodologies
Payment rates
Interpersonal relationships
Policy analysis
Word processing
Spreadsheet software
Statistical software
Complex formulas
Briefing documents
Project management
Business Objects
SQL based data querying software

Location

AUSTIN

Work Type

Eligible for Telework
Regular
Full time

Experience Level

Highly complex (senior-level)

Education Level

Graduation from an accredited four-year college or university with a bachelor’s degree in social science; business, including accounting and statistics; mathematics; economics; health-related field; political science; or other closely related field.
Experience may be substituted on a year-for-year basis.

Salary/Compensations

$4,523.16 - $7,253.83 Monthly

Benefits

100% paid employee health insurance for full-time eligible employees
Defined benefit pension plan
Generous time off benefits
Numerous opportunities for career advancement

About the Company

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.

Equal Opportunity

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.
HHSC uses E-Verify.