Healthcare Financial Data Analyst

TX-HHSC-DSHS-DFPS • Austin, TX

1d • $5,281 - $7,281 • Hybrid

About The Position

This hybrid position performs advanced (senior-level) financial analysis and financial regulatory work related to the activities of the Special Projects and Data Analysis unit within Financial Reporting and Audit Coordination. Work involves monthly processing of the Delivery Supplemental Payments (DSP), performing Financial Statistical Report (FSR) to Encounter Reconciliations and other Special Projects and Data Analysis projects. Responsibilities include reviewing, analyzing, and evaluating financial data; preparing reports and responding to inquiries; and recommending appropriate action to resolve financial and regulatory problems. This position reports to the Manager of Special Projects and Data Analysis unit and works under minimal supervision with extensive latitude for the use of initiative and independent judgement. The position utilizes institutional knowledge of Medicaid and calls upon their experience in the intricacies of Medicaid financial reporting to design, implement and maintain financial reporting methods and financial oversight practices for Managed Care Organization (MCO) financial deliverables.

Requirements

• Graduation from an accredited four-year college or university with major coursework in accounting, math, finance, business administration, or statistics.
• Education and experience in finance may be substituted for each other on a year-for-year basis.
• Knowledge of financial data analysis principles and techniques, accounting principles, and auditing.
• Relevant education plus multiple years' experience in accounting and/or finance, with a solid grasp of financial and industry terminology and practices.
• Strong problem-solving, organizational, and analytical skills.
• A working knowledge of healthcare management and healthcare insurance programs, and/or MCOs is required.
• Ability to design and perform numerical analyses to develop conclusions from data.
• Ability to interpret statutes, evaluate and summarize financial issues, and assess conformance to procedures, rules, and requirements.
• Ability to research and interpret contracts, policies, and procedures.
• Ability to take responsibility and ownership of projects and processes to assure successful quality completion.
• Ability to follow instructions when given, and the ability to perform well under minimal supervision.
• Capability to be flexible.
• Ability to be consistently accurate, very detail-oriented, and highly organized.
• Possessing a habit of wanting to "get it done efficiently and accurately".
• Demonstrating self-initiative, going beyond the minimum, looking for opportunities for improvement and making suggestions for increased efficiency and accuracy.
• Robust record-keeping, file-management, and follow-up skills.
• Ability to develop positive and productive relationships with external and internal financial on-financial personnel.
• Ability to work effectively as a strong contributing team member in a deadline-oriented environment; being a reliable, productive, and flexible contributor, with a positive attitude and a desire to learn.
• Skill in using PC software, particularly proficiency in MS Excel, PowerPoint, Outlook and Word.
• Skill in written and oral communication, including producing reports and making occasional public presentations.
• Ability to research and develop financial policies and procedures.
• Ability to draft clear and concise correspondence regarding findings.
• Experience in managing multiple projects with varying priorities.
• The ability to devise solutions to develop and evaluate administrative policies and procedures.
• The ability to prepare cogent and meaningful reports and presentations and to communicate with peers and superiors effectively.

Nice To Haves

• Knowledge of state and federal rules and laws related to the Medicaid and CHIP Programs preferred.
• Experience working in Government or at an MCO would be helpful.
• Motivated self-starter who consistently demonstrates initiative.
• Exhibits a strong drive to enhance financial operations.
• Proven capability to learn new material quickly, and to be self-taught.
• Demonstrated track record of developing improvements and finding new ways to add value to the organization.
• Capabilities with Business Objects, MS Access or other database software, Power BI, SQL, VBA, and HHSC software such as TIERS would be a significant plus.

Responsibilities

• Performs the duties of monthly DSP claims processing, report creation, DSP appeals processing, and initiating policy/procedure changes and other DSP-related matters, as well as responding to inquiries about DSP claims processing and policies.
• Keeps informed of and interprets any changes to Medicaid rules or regulations pertaining to Delivery Supplemental payments.
• Assists with developing financial Reporting Policies and Procedures to support and comply with those policies.
• Provides support to all program areas within MCS on all issues related to the DSP payments.
• Develops new or revised DSP claim report templates and forms.
• Coordinates with HHSC IT to plan, improve, and implement updates to the DSP Application.
• Provides guidance, data, and consultative services to MCS program areas, including HHSC Provider Finance, Actuarial Analysis, HHSC Internal Audit, HHSC Inspector General; Texas State Auditor's Office and any other Federal and State entities regarding Delivery Supplemental payment processes; responds to audit inquiries, presents results to management, and makes recommendations.
• Keeps DSP-related manuals and policy and procedure documents up to date.
• May train and lead junior staff, if needed.
• Develops standard and ad-hoc reporting while providing financial analysis support and expertise in taking on other special projects, including Quality Improvement Expense Reporting and supporting internal stakeholders within FRAC and MCS divisions.
• Ensures compliance with new procedures, requirements, laws, and regulations; completeness of data; and presence of adequate documentation.
• Assists with the quarterly encounter to FSR Paid Claim reconciliations, creating reports on reconciliation results and presenting the results to Medicaid CHIP Services Stakeholders to highlight and discuss MCO compliance issues.
• Collaborates with Managed Care Contracts & Oversight teams to provide reconciliation reports to the MCOs and solicit MCO response with respect to the root cause of any noncompliance and MCOs’ resolution of any issues; maintains a log of MCO historical compliance status and communication related to MCO noncompliance; recommends MCO sanctions and liquidated damages to the Manager, as appropriate.
• Prepares timely instructions or clarifications to the MCOs regarding the proper application of new or revised contractual requirements related to financial and/or encounter reporting in coordination with MCS Operations.
• Helps with developing training, Policy, and Procedure documents related to the reconciliation process, providing Fiscal year-end reconciliations, and coordinating with Actuarial Analysis to assist in certification of year-end encounters data by the HHSC EQRO (External Quality Review Organization).
• Researches and interprets rules and regulations; responds to information requests by internal and external stakeholders.
• This includes collecting and distributing reports, contract documents; relevant statute or regulatory citations; department policies and procedures and desk manuals.
• Recommends improvements to contract monitoring methodologies to the Manager.
• The position also suggests ways to do things more effectively.
• Works to expand knowledge and capabilities.

Benefits

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

What This Job Offers

• Job Type: Full-time
• Career Level: Senior