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Texas Health and Human Services · 2 hours ago

Reimbursement Analyst V

Austin, TX

Contract

Hybrid

Senior Level

$5,797.66/mo - $9,508.25/mo

Texas Health and Human Services is committed to creating a positive impact in the lives of fellow Texans. The Reimbursement Analyst V serves as the lead reimbursement analyst for Acute Care services Fees team, conducting detailed data analysis, generating recommendations, and providing guidance for operational and tactical planning.

Health Care

No H1B

Responsibilities

Attends work on a regular and predictable schedule in accordance with agency leave policy and performs other duties as assigned

Reimbursement Rate Reviews – Keeps rate reviews and rate hearing steps on schedule. Review analysts’ fiscal estimates, identify and correct issues, and provide recommendations as needed. Review and complete required notices, postings, and publications for public rate hearings and rate implementations. Prepare documents for, meet with and brief executive staff on proposed initiatives. (35%)

Fiscal Analysis – Complete detailed fiscal analysis, pricing reviews, methodology recommendations for provider reimbursement for a variety of programs administered by HHSC. Work includes compiling information from a variety of datasets, with varying degrees of size and complexity. Includes special projects, ad-hoc requests, and agency-directed initiatives. (20%)

Federal and State Compliance – Proactively manage workflow to meet all required notices and submission of State Plan Amendments (SPA) and Texas Administrative Code (TAC) updates. Review work of other analysts to ensure accuracy of work related to SPA and TAC updates related to changes to reimbursement rates. Respond to legislative inquiries, complete bill analysis, draft and estimate fiscal impacts, meet with legislative staff and/or attend hearings as required. (20%)

Team Representation – Approve biennial workplan, deadline extensions, issues, resolving errors in information received, and implementation status with state contractor(s). Represent team as a Subject Matter Expert in collaborative efforts with other teams internal to the agency and external stakeholders. (20%)

Performs other work as assigned or required to maintain and support the office and HHSC operations. (5%)

Qualification

Data analysisSQLReimbursement methodologiesMicrosoft OfficeClaims processing enginesHealthHuman servicesPublic speakingCommunicationProblem-solvingTeam collaboration

Required

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