Reimbursement Analyst V

TX-HHSC-DSHS-DFPS•Austin, TX

3d•$5,798 - $9,508•Hybrid

About The Position

This position is hybrid with (currently) two in-office days per week in Austin. Applicants from outside Texas must be willing to relocate within 30 days of hire. The Reimbursement Analyst V (RAV) position works on Acute Care and Hospital related program for the Provider Finance Department. Work involves maintaining complex applications, spreadsheets, and databases used in the determination of payment rates and reporting, as well as strategic operations and planning. The RAV generates and summarizes written documentation to comply with state and federal rules and regulations, conducts executive briefings, interacts and responds to executive staff requests, and responds to inquiries from providers and other staff as required. Provides guidance for operational and technical planning, program development, and data analysis and evaluation related to services and issues. Work involves establishing goals and objectives, drafting and maintaining policies and procedures, and keeping work products on track to meet deadlines; consulting on priorities, standards, measurement tools, and reporting systems for determining progress in meeting goals. Works under minimal supervision, with extensive latitude for the use of initiative and independent judgment.

Requirements

Graduation from an accredited four-year college or university with a bachelor’s degree in social science; business, including accounting and statistics; mathematics; physics; economics; health-related field; political science; or other closely related field.
Education and work experience can be substituted for one another on a year-for-year basis.
Advanced Microsoft Office (Excel, Word, PowerPoint), business objects, TMHP Software, claims processing engines, and data querying/analysis tools such as SQL, R, SAS, Python.
Data analysis, statistics, data visualization, medical claims data, methods of funding, program rules, Medicare, and Medicaid.
Reimbursement methodologies.
Texas legislative process.
Health and human service programs, services, and procedures.
Data quality and integrity processes.
Process improvement or quality assurance systems
Managing multiple and competing priorities.
Identifying problems, evaluating alternatives, and implementing solutions.
Working collaboratively and cooperatively with diverse groups.
Communication and public speaking.
Interpret data and develop effective operating procedures.
Work with large datasets efficiently.
Organize and present information effectively, both orally and in writing to technical and non-technical audiences.
Establish goals and objectives.
Train and provide constructive feedback to staff.
Establish effective working relationships with staff at all levels of an organization, agencies, providers, and stakeholders.
Exercise independent judgment, set priorities, meet deadlines, and adapt to shifting technical and political developments

Nice To Haves

Experience with Medicaid and/or healthcare finance preferred.

Responsibilities

Attends work on a regular and predictable schedule in accordance with agency leave policy and performs other duties as assigned.
Develops and implements complex data analysis to determine payment rates for the Acute Care and Hospital finance related programs.
Designs and conducts special cost and statistical research and analysis to evaluate the feasibility and the cost implications about payment rate structure options, new program initiatives or enhancements, special payment rate initiatives, and new regulations.
Develops, modifies, and maintains complex computer programs, spreadsheets, and large databases used in payment rate analysis. (30%)
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 Acute Care and Hospital related programs.
Sends state action requests to implement rates for new benefits or for updates. (25%)
Proactively manage workflow to meet all required notices, submission, and publication of state and federal reports, State Plan Amendments (SPA), and Texas Administrative Code (TAC) updates.
Review work of other analysts to ensure accuracy and quality of work.
Respond to legislative inquiries, complete bill analysis, draft and estimate fiscal impacts, meet with legislative staff and/or attend hearings as required.
Ensures team adherence to established procedures, quality standards, and deliverable timelines. (20%)
Create, define, and document processes and procedures (P&Ps).
P&Ps should facilitate team consistency, quality, knowledge retention, training, efficiency, and productivity.
Maintain P&P documents to reflect current-state processes and continuous improvement.
Ensure team is knowledgeable and comply with P&Ps. (20%)
Performs other work as assigned or required to maintain and support the office and HHSC operations. (5%)