Business Analyst II (Medicaid Managed Care Encounter Analyst)

Texas Health & Human Services Commission•Austin, TX

34d•$5,099 - $6,702•Onsite

About The Position

The Texas Health and Human Services Commission’s Medicaid and CHIP Services department is seeking an Information Technology Business Analyst II for its Encounters and File Support team. The position manages operational issues related to Medicaid encounters, which document services delivered to Medicaid and CHIP beneficiaries enrolled in managed care plans, as well as other vendor activities. The analyst performs complex, journey-level business analysis to improve information technology solutions in support of Medicaid business needs and provides technical analysis and guidance to agency areas on policies and procedures supporting Medicaid Enterprise Systems (MES), including file support and coordination. The role works under general supervision, with moderate latitude for initiative and independent judgment. The selected candidate must work onsite in the Austin office. Some travel, including occasional overnight trips, may be needed. The position may be eligible for telework, subject to agency policy, supervisor discretion, and business needs.

Requirements

Bachelor’s degree from an accredited college or university and at least 3 years of progressively responsible experience in technical leadership, project management, or account management; alternatively, at least 7 years of relevant professional experience, including at least 3 years leading technical initiatives, managing projects, or managing customer relationships.
Experience in systems or business analysis.
Experience with health providers, managed care organizations, or external vendors.
Knowledge of Medicaid or CHIP programs and policies; automated systems techniques; customer relations principles and practices; policies and procedures used in managed care, health care, health insurance, or health and human services programs; and relationships among agency systems for provider enrollment, client eligibility, and claims payment, including supporting technologies.
Skill in coordinating and solving problems; communicating effectively with technical and non-technical staff; reviewing technical requirements for vendor best practices and technology; establishing and maintaining effective working relationships; and using personal computer application software such as Microsoft Office (Outlook, Teams, Word, Excel, PowerPoint), including advanced Excel or similar programs.
Ability to ensure systems meet business user requirements; research, evaluate, and make recommendations on oversight issues; gather and analyze information from varied sources to identify trends, issues, and findings and communicate them effectively; and work cooperatively as a team member.
Job history must demonstrate that the applicant meets the initial selection criteria.
Selected candidate must be able to work onsite in the Austin office.
Out-of-state resumes will not be accepted.

Nice To Haves

Degree specialization in a business, technology, or health-related discipline.
Experience with Medicaid, CHIP, or Medicaid Managed Care policies.
Experience with Medicaid claims or encounters.
Experience with Agile methodologies or processes.
Experience with auditing or fiscal monitoring.

Responsibilities

Monitor, assess, and manage data issues related to Medicaid encounters; develop agendas, facilitate workgroup and stakeholder meetings, coordinate discussions about encounter data and errors, and prepare briefings on status, issues, and recommendations.
Represent the Encounters unit as a liaison with Medicaid and CHIP programs, managed care organizations, TMHP, Information Technology, and other stakeholder groups.
Gather, develop, and document user requirements for automation of new or improved systems and business operations.
Monitor and analyze encounter submission errors to identify performance trends and recommend program improvements or contract enhancements.
Research and analyze operational issues, including applicable rules, policies, and regulations related to timely and accurate encounter processing.
Support and coordinate operational files for Medicaid Enterprise Systems functionality, and prepare diagrams and flow charts to track system interface files.
Provide subject matter expertise and technical assistance for readiness reviews related to Medicaid and CHIP encounter processing and reporting.
Assess vendor compliance and ability to deliver services in accordance with contract terms and requirements.
Keep the supervisor informed about challenging problems and recommend appropriate actions.
Perform other duties assigned by the supervisor, including administrative functions or supporting the Medicaid/CHIP division.