Research Specialist V (Rate Research and Implementation)

Location: Austin, TX

About the role

Research Specialist 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. This includes 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.

This position 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, the Research Specialist V will mentor junior staff, perform reviews on peers' work, engage in staff training on research methods and LTSS rate methodologies, and help ensure work is completed accurately and meets required deadlines. The role works under minimal direction with extensive latitude for the use of initiative and independent judgment.

The Research Specialist V develops and implements research and analytical procedures to assess the validity of methods and/or procedures for appropriate application. The role 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. The Research Specialist V prepares memorandums and white papers regarding the research and analysis performed for Executive leadership.

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 alignment with State and Federal guidelines and regulations, Texas Administrative Code, and industry 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 influence HHSC’s outcomes goals for clients; communicates and advises the Director of LTSS Finance regarding progress toward these objectives upon request. (35%)
• Drafts memorandums, white papers, state plan amendments, and rule amendments based on analyses; conducts public hearings; prepares independent reports and presentations on analysis results for staff and department leadership.
• Delivers oral presentations and reports on financial programs and initiatives to provider and stakeholder organizations and HHSC leadership; communicates complex results in an easily understandable manner for 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 issues.
• Prepares information and reports for professional organizations, stakeholders, federal personnel, other governmental entities, Executive staff, and the public regarding long-term research objectives and outcomes. (35%)
• 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 participating in training new hires on technical aspects of their positions.
• Serves as a subject matter expert on LTSS rates and reimbursement methodologies; contributes to internal training efforts. (15%)
• Actively contributes to the continuous improvement of department processes through initiatives such as automating solutions, building efficiencies, and maintaining consistency across multiple models and rate calculations.
• Creates and updates policies and procedures for documenting internal processes and resources. (10%)
• Performs other duties as assigned, including actively participating and/or serving in a supporting role to meet the agency’s obligations. (5%)

Requirements

• Graduation from an accredited four-year college or university (required). Major coursework in accounting, business administration, finance, economics, statistics, or a related field is preferred. Practical experience in these fields may substitute for major coursework.
• At least two years of experience in accounting, Medicaid/Medicare, healthcare business, statistics, finance, or other relevant fields.

Skills

• 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, 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 judgment in evaluating situations and making recommendations.
• Ability to communicate complex information to various audiences.
• Knowledge of research methods, principles, and techniques.
• Knowledge of principles for calculating fiscal estimates is preferred.
• Knowledge of reimbursement rate development is preferred.

Benefits

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: $5,425.33 - $8,886.16 per month.

Schedule

• Full-time, regular position.
• Day shift.
• Eligible for telework, with in-office presence required two days a week (may be modified based on business need).
• Occasional travel may be required (up to 5%).