Research Specialist V (Rate Research and Implementation)

TX-HHSC-DSHS-DFPS•Austin, TX

1d•$5,425 - $8,886•Hybrid

About The Position

Research Specialist (RS) V reports to the Manager of the Rate Research and Implementation (RRI) team within the Long-Term Services and Supports (LTSS) section of the Provider Finance Department (PFD) and performs advanced (senior-level) research and rate setting work, including evaluation of existing, new or alternative rate methodologies for Medicaid and non-Medicaid services. The work involves research of state and federal regulations, analysis of Texas rate setting and reimbursement methodologies, and those used in other states, and general policy research and other research projects as assigned. RS V serves as a team lead and subject matter expert in LTSS rates and methodologies, including updating pro-forma rate models and rate calculations. Under the direction and assistance of the RRI Manager, RS V will mentor junior staff, perform reviews on peer’s work, engage in staff training on research methods and LTSS rate methodologies, and help to ensure work is completed accurately and meets required deadlines. This position works under minimal direction with extensive latitude for the use of initiative and independent judgment. RS V develops and implements research and analytical procedures to assess the validity of methods and/or procedures for appropriate application. RS V also prepares a variety of reports, studies or other deliverables for internal and external audiences containing research results related to the rate setting process. This position is expected to make presentations related to research and rate setting work and represent the PFD in meetings with internal and external stakeholders. RS V prepares memorandums and white papers regarding the research and analysis performed for Executive leadership. The RS V performs other duties necessary to achieve the mission of the Health and Human Services Commission (HHSC).

Requirements

Graduation from an accredited four-year college or university, required.
At least two years of experience in accounting, Medicaid/Medicare, healthcare business, statistics, finance, or other relevant fields.
Ability to analyze or evaluate research data and findings.
Ability to establish and maintain effective work relationships in a team setting.
Ability to differentiate between various professional circumstances and communicate effectively in writing, in speaking, and nonverbally.
Ability to edit narrative reports.
Ability to learn and effectively apply new procedures and techniques.
Ability to follow established guidelines and find ways to improve internal processes.
Ability to organize, track, work independently, and complete simultaneous difficult/complex tasks with varying deadlines.
Ability to exercise good judgement in evaluating situations and making recommendations.
Ability to communicate complex information to various audiences.
Knowledge of research methods, principles, techniques.

Nice To Haves

Major coursework in accounting, business administration, finance, economics, statistics, or a related field is preferred. Note: practical experience in these fields may be substituted for major coursework.
Knowledge of principles for calculating fiscal estimates is preferred.
Knowledge of reimbursement rate development is preferred.

Responsibilities

Performs advanced research related to HHSC’s Medicaid and non-Medicaid rate methodologies necessary to develop LTSS reimbursement rates and supplemental payment programs.
Contributes to LTSS rate setting work by refining LTSS pro-forma rate models to ensure that they align with State and Federal guidelines and regulations, Texas Administrative Code, and industry’s best practices.
Provides consultation and technical advice on research methods and techniques to staff on the research team and other rate analysts in the department.
Reviews, analyzes, and evaluates the impact of legislation, regulations, and policies affecting reimbursement rates and healthcare finance, reports results and makes recommendations to PFD Leadership, Executive staff, including the Executive Commissioner and other key personnel.
Formulates and monitors long-term research objectives, programs, and priorities needed to develop new reimbursement techniques and to evaluate how reimbursement rates are influencing HHSC’s outcomes goals for clients; communicates to and advises the Director of LTSS Finance regarding the progress towards the long-term research objectives upon request.
Drafts memorandums, white papers, state plan amendments, rule amendments based on analyses, conducts public hearings; prepares independent reports and presentations on analyses results to other staff and department leadership on a routine basis; delivers oral presentations and reports on financial programs and initiatives to various provider and stakeholder organizations and to HHSC leadership; communicates complex results in a manner that can be easily understood by various audiences including public stakeholders.
Represents programs in committees, regional workgroups, and projects to meet research and data analysis needs.
Represents the state at the national level on research and data analysis issue.
Prepares information and reports for professional organizations, stakeholders, federal personnel, other governmental entities, Executive staff, and the public regarding the long-term research objectives and outcomes of that research.
Provides guidance to PFD LTSS staff on research and analytical methods used in support of rate methodologies and/or research projects.
Assists in hiring and conducts training of junior staff, including regularly participating in training new hires on various technical aspects of their positions, as well as participating in interview and selection teams as needed.
Assists with consulting other staff about policy guidelines and rule requirements.
Serving as a subject matter expert of LTSS rates and reimbursement methodologies, RS V is expected to contribute to internal training effort.
Actively contributes to the continuous improvement of department processes through ongoing initiatives including: solutions to automate; building efficiencies; maintaining consistency across multiple models and rate calculations.
Creates and updates policies and procedures for documenting internal processes and resources.
Actively participating and/or serving in a supporting role to meet the agency’s obligations.