Reimbursement Analyst III (Non-Medicaid and DFPS Rates)

TX-HHSC-DSHS-DFPS•Austin, TX

5d•$5,099 - $8,305•Hybrid

About The Position

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. Under direct supervision of the Manager of the Non‑Medicaid and DFPS Rates team within the Provider Finance Department (PFD) Long-Term Services and Supports (LTSS) section, Reimbursement Analyst III (RA III) performs advanced (senior-level) rate analysis focused on the reimbursement payment rates and rate setting methodologies. Work includes developing and implementing policy and financial analysis to determine and evaluate payment rates and rate setting methodologies and other related policies and regulations; preparing cost surveys, instruments, and instructions; and planning, developing, and presenting recommendations and reports. RA III plans, develops, and presents recommendations and reports and works under minimal supervision, with extensive latitude for the use of initiative and independent judgement. RA III will serve as a senior analyst and subject matter expert in non-Medicaid rates and methodologies, as well as rate setting 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.

Requirements

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.
Graduation from a four-year college or university required.

Nice To Haves

Data analysis methods and techniques (preferred).
Principles and practices of rate setting and payment methodology development (preferred).

Responsibilities

Supports development and implementation of policy and financial analysis to determine and evaluate payment rates for various non-Medicaid programs and services. Develops, implements, and maintains rate methodologies and rate calculations. Work includes preparing ad hoc financial analyses and fiscal estimates. (35%)
Supports the design and study of special cost, statistical research, cost surveys and analysis to evaluate the feasibility and cost implications regarding payment structure options, new program initiatives, and new regulations. Contributes to cost report or cost surveys to support rate methodology or programmatic changes. Interprets analysis results and develops recommendations for internal and external audiences. (25%)
Prepares memoranda and white papers for Executive Leadership, drafting and reviewing of documents as necessary. Develops and processes policy documents relating to payment rate and methodology determination, including state administrative rules, etc. (15%)
Serves as a subject matter expert of Non-Medicaid reimbursement methodologies, models, data, policies and procedures. Communicates and interfaces with internal and external parties to provide guidance and resolve problems concerning reimbursement rates or payments; rate methodology; rate determination and policy, guidelines, and rule requirements. Provides guidance to PFD LTSS staff on analytical methods used in support of rate methodologies and/or projects. Assists in hiring, mentoring, and training of junior staff. (15%)
Actively contributes to the continuous improvement of department processes though ongoing initiatives including: solutions to automate; building efficiencies; maintaining consistency across multiple calculations, models, and rules, promoting reliable analysis techniques and methods. Creates and updates policies and procedures for documenting internal processes and resources, including standard forms and templates. (10%)