Reimbursement Analyst III

Location: Austin, TX

About the role

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.

Responsibilities

• Development and Analysis (35%): Manages the development and implementation of complex data analysis to determine payments for assigned programs. Develops, modifies, and maintains complex computer programs, spreadsheets, and large databases used in rate and/or payment analysis.
• Oversight of Payment Programs (30%): Oversees development, implementation, and processing for Long-Term Services and Supports (LTSS) directed payment programs. Develops and maintains payment rate models used to make accurate and timely payments to program participants. Ensures program procedures and associated processes conform to Texas Administrative Code requirements, and state and federal statutes, rules, and guidelines. Designs data collection instruments and detailed instruction manuals to collect eligibility and enrollment data from contracted providers for use in determining compliance with applicable requirements.
• Stakeholder and Staff Communications (20%): Interfaces with various Provider Finance Department (PFD) staff, provider industry representatives, HHS Enterprise staff, legal staff, advisory committees, workgroups, and other interested parties concerning program payments, eligibility, and funding. Communicates complex information to internal and external parties to provide, exchange, or verify information, answer inquiries, address issues, or resolve problems or complaints.
• Drafts Documents for Approval and Presentation (10%): Develops department policies and procedures as the subject matter expert for the team and processes policy documents. Drafts policy guidelines, agency rules, state plan amendments, and other associated documents. Develops and implements new program initiatives or enhancements, and new regulations.
• Other Duties (5%): Performs other duties as assigned and as required to maintain efficient program and agency operations.

Requirements

• Graduation from an accredited 4-year college or university. Experience within Provider Finance may be substituted for education on a year-to-year basis.
• At least one year of experience in advanced written and verbal communication and one year of experience working with large amounts of data, developing payment rates, or conducting complex cost analyses.
• At least one year of experience in interpreting state and federal laws and regulations relating to Medicaid reimbursement rates or in the development, implementation, and maintenance of supplemental payment programs (preferred).

Skills

• Advanced skill in Microsoft Excel.
• Skill in developing, implementing, interpreting, and evaluating policies, procedures, regulations, and laws.
• Ability to exercise independent judgment, set priorities, meet deadlines, and adapt to shifting technical and political developments.
• Ability to plan, organize, and coordinate the work of others.
• Ability to establish goals and objectives, coordinate the achievement of established goals and objectives, and identify problems and develop creative solutions.
• Ability to communicate effectively both orally and in writing with a variety of agency staff, medical/provider associations, legislative staff, lawyers, state/federal auditors, and interested parties on Medicaid reimbursement issues.

Benefits

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.

Explore more details on the Benefits of Working at HHS webpage.

Pay

Salary Range: $5,098.66 - $8,304.83 per month

Schedule

• Shift: Day
• Full-time
• FLSA Status: Exempt
• Eligible for telework
• Travel: Up to 5%