Reimbursement Analyst III

TX-HHSC-DSHS-DFPS•Austin, TX

1d•Hybrid

About The Position

This job posting will be used to fill a position in the Chief Financial Officer (CFO) Division in the Provider Finance Department. The Reimbursement Analyst III is selected by and reports to the Supplemental Payments Program Manager. This position provides advanced technical guidance and oversees the design and implementation of complex methods and procedures. Duties may include some or all of the following: Conducts complex data analysis to determine and evaluate payment rates; manages the development and implementation of reimbursement methodologies and payment rates; provides effective planning, organization and guidance to staff; analyzes cost report information, provides effective planning, organization, direction to staff; and identifies needed areas of change. The Reimbursement Analyst III also: oversees the collection of appropriate statistical and cost data necessary to determine payment rates; Manages the development, modification and maintenance of complex computer programs, spreadsheets and large databases used in determining payment rates; Develops alternative strategies and recommendations; implements new program initiatives or enhancements, and new regulations; interfaces with diverse groups, including other agency staff, provider associations, workgroups, advisory committees, legislative staff, client advocates, attorneys, state and federal auditors, and interested parties; Develops policy guidelines, agency rules, state plan amendments and other associated documents; Conducts public rate hearings; and, provides technical assistance to contracted providers, report/survey preparers and auditors. Performs other duties as assigned and required to maintain efficient program and agency operations.

Requirements

Graduation from an accredited 4-year college or university required.
Relevant experience (e.g., experience in the field of financial analysis, reimbursement analysis, rate development, financial examination, and accounting) may be substituted for education on a year-to-year basis.

Nice To Haves

Experience in managing large projects with numerous deadlines, preferred.
Experience in designing and conducting complex data analyses, preferred.
Experience with basic accounting principles, applying accounting or statistics, including use of statistical applications, preferred.
Experience in using word processing, spreadsheet, statistical and other software, preferred.
Experience in applying accounting or cost determination principles, reviewing and analyzing financial and statistical information, preferred.
Experience in state and federal laws and regulations relating to Medicaid reimbursement rates, preferred.

Responsibilities

Manages the development and implementation of complex data analysis to determine payment rates for Medicaid and other programs.
Develops, modifies, and maintains complex computer programs, spreadsheets and large databases used in rate and/or payment analysis.
Provides advanced technical guidance, effective planning, organization, and direction to staff in the department to meet internal, legislative, State and/or Federal requirements.
Communicates complex information to internal and external parties to provide, exchange or verify information, answer inquiries address issues or resolve problems or complaints.
Interfaces with various contracted providers, provider representatives, client advocates, other agency staff, advisory committees, workgroups, attorneys, and other interested parties concerning payment rate policy issues affecting program delivery and payment rate determination.
Develops department policies and procedures as the subject matter expert for the team and processes policy documents (including but not limited to policy guidelines, agency rules, state plan amendments, council and advisory committee items, workgroup materials, and hearing and other notices).
Develops and/or conducts surveys to collect cost data for use in payment analysis.
Designs cost data collection instruments and detailed instruction manuals to collect cost data for feasibility of use in payment rate analysis.
Provides technical assistance related to cost survey completion, policy guidelines and rule requirements.
Performs other work assigned or required to maintain and support the office and HHSC operations.