Program Specialist (PFD LTSS Non-Medicaid and DFPS Rates)

TX-HHSC-DSHS-DFPS•Austin, TX

7d•$5,099 - $8,305•Hybrid

About The Position

Under direct supervision of the Manager of DFPS and Non‑Medicaid Rates Team within the Provider Finance Department (PFD) Long-Term Services and Supports (LTSS) section, Program Specialist (PS) VI performs advanced, complex program and policy work related to the development, implementation, monitoring, and maintenance of cost reporting processes and payment rates and reimbursement methodologies for non-Medicaid programs and services, including pro forma and cost report-based rate modeling. PS VI assists in cost reporting processes, the development of cost reporting instructions, addressing cost report inquiries, the development of rate models and fiscal estimates in support of HHSC’s Memorandum of Understanding with the Department of Family and Protective Services (DFPS) and the Texas Juvenile Justice Department (TJJD) for rate-setting activities. PS VI works under limited supervision with considerable latitude for initiative and independent judgment.

Requirements

Graduation from a four-year college or university is required.
Relevant experience in state government, reimbursement methodology, finance, communications, training, or a related field may substitute on a year-for-year basis.
Knowledge of financial analysis, accounting concepts, budgeting, cost allocation, and reimbursement principles.
Knowledge of program evaluation, policy analysis, and report development.
Knowledge of applicable state and federal laws, regulations, policies, and procedures related to assigned programs.
Skill in analyzing complex financial, statistical, and programmatic information.
Skill in developing and maintaining spreadsheets, financial models, workpapers, and data files.
Skill in interpreting data and communicating findings to technical and nontechnical audiences.
Skill in preparing clear, accurate, and concise reports, correspondence, training materials, and presentations.
Skill in organizing workload, managing multiple projects, and meeting established deadlines.
Skill in using personal computers and standard business software, including Microsoft Excel, Word, PowerPoint, and Outlook.
Ability to apply sound judgment and independent decision-making to complex program and financial issues.
Ability to develop defensible rate-setting analyses and reimbursement recommendations.
Ability to explain technical financial and reimbursement concepts clearly to providers, program staff, leadership, and other stakeholders.
Ability to establish and maintain effective working relationships with internal and external stakeholders.
Ability to work effectively both independently and collaboratively in a team environment.
Ability to maintain confidentiality of sensitive provider, financial, and program information.

Nice To Haves

Data analysis methods and techniques (preferred).
Principles and practices of rate setting and payment methodology development (preferred).
Demonstrated experience in: coordinating a program within a state agency; deliverying customer service; developing or providing stakeholder communications; deliverying virtual/in-person training; cost reporting processes; or reimbursement methodologies is preferred.

Responsibilities

Participates in provider cost-reporting activities, including reporting requirements, submission timelines, provider instructions, data collection, review processes, and follow-up.
Reviews provider cost reports and supporting documentation for completeness, consistency, reasonableness, and compliance with applicable requirements.
Identifies data-quality concerns, analyzes cost-reporting trends, and coordinates resolution of complex reporting or reimbursement issues.
Develops reports, memoranda, summaries, presentations for executive leadership, as well as guidance documents for provider communications, and other materials describing rate-setting analyses, reimbursement methodologies, cost-reporting requirements, and fiscal impacts.
Provides technical assistance and training to providers, program staff, and other stakeholders on cost reporting, reimbursement concepts, rate-setting processes, and data-submission requirements.
Responds to complex stakeholder inquiries and explains cost reporting processes, financial analysis, rate-setting functions, and reimbursement information to technical and nontechnical audiences.
Assists in developing, analyzing, implementing, and maintaining payment rates, reimbursement methodologies, and related financial models for assigned non-Medicaid programs and services.
Conducts financial, statistical, and policy analyses to support rate recommendations, methodology changes, fiscal impact estimates, and leadership decision-making.
Assists in the preparation and maintenance of rate-setting workpapers, calculation files, assumptions, supporting documentation, and recommendations for review and approval.
Collaborates with program, finance, budget, legal, contract, data, and information technology staff to obtain data, implement rate-setting activities, and address reimbursement-related issues.
Assists with development and maintenance of policies, procedures, desk references, process documentation, and implementation plans related to assigned programs.
Supports audits, legislative requests, public-information requests, stakeholder meetings, and other provider finance initiatives.
Performs related work and special projects as assigned to support Provider Finance and LTSS operational priorities.