This job posting will be used to fill a position in the Chief Financial Officer (CFO) Division in the Provider Finance Department. The Reimbursement Analyst II is selected by and reports to the Supplemental Payments Program Manager. This position provides advanced technical guidance and oversees the design and implementation of complex methods and procedures.
Duties may include some or all of the following: Conducts complex data analysis to determine and evaluate payment rates; manages the development and implementation of reimbursement methodologies and payment rates; provides effective planning, organization and guidance to staff; analyzes cost report information, provides effective planning, organization, direction to staff; and identifies needed areas of change. The Reimbursement Analyst II also: oversees the collection of appropriate statistical and cost data necessary to determine payment rates; Manages the development, modification and maintenance of complex computer programs, spreadsheets and large databases used in determining payment rates; Develops alternative strategies and recommendations; implements new program initiatives or enhancements, and new regulations; interfaces with diverse groups, including other agency staff, provider associations, workgroups, advisory committees, legislative staff, client advocates, attorneys, state and federal auditors, and interested parties; Develops policy guidelines, agency rules, state plan amendments and other associated documents; Conducts public rate hearings; and, provides technical assistance to contracted providers, report/survey preparers and auditors. Performs other duties as assigned and required to maintain efficient program and agency operations.
Essential Job Functions:
1. Manages the development and implementation of complex data analysis to determine payment rates for Medicaid and other programs. Develops, modifies and maintains complex computer programs, spreadsheets and large databases used in rate and/or payment analysis. (25%)
2. Provides advanced technical guidance, effective planning, organization and direction to staff in the department to meet internal, legislative, State and/or Federal requirements. (20%)
3. 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 payment rate policy issues affecting program delivery and payment rate determination. (20%)
4. Develops department policies and procedures as the subject matter expert for the team and processes policy documents (including but not limited to policy guidelines, agency rules, state plan amendments, council and advisory committee items, workgroup materials, and hearing and other notices). (15%)
5. Develops and/or conducts surveys to collect cost data for use in payment analysis. Designs cost data collection instruments and detailed instruction manuals to collect cost data for feasibility of use in payment rate analysis. Provides technical assistance related to cost survey completion, policy guidelines and rule requirements. (10%)
6. Performs other work assigned or required to maintain and support the office and HHSC operations. (10%)
Knowledge Skills Abilities:
Knowledge of health and human service programs, services, and procedures
Knowledge of Medicaid reimbursement principles and policies
Skill in interpersonal relationships, teamwork and establishing and maintaining effective working relationships with people at various levels of expertise.
Ability to manage projects effectively and to produce quality work within short deadlines.
Ability to work under limited supervision, exercise independent judgment, set priorities, meet deadlines and adapt to shifting technical and political developments.
Ability to communicate knowledge effectively to a variety of audiences, both verbally and in writing.
Ability to prepare well written briefing documents and reports, and visually dynamic presentations.
Ability to identify problems, evaluate alternatives, and implement effective solutions.
Ability to learn and teach complex, detailed concepts.
Knowledge of the Texas legislative appropriations process
Knowledge of the HHSC rules process and procedures
Knowledge of the HHSC Executive Memorandum and Correspondence style guide
Registration or Licensure Requirements:
None
Initial Selection Criteria:
Graduation from an accredited 4-year college or university. Relevant experience may be substituted for education on a year to year basis.
Experience in managing large projects with numerous deadlines, preferred.
Experience in designing and conducting complex data analyses, preferred.
Experience with basic accounting principles, applying accounting and/or statistics, including use of statistical applications, preferred.
Experience in using word processing, spreadsheet, statistical and other software, preferred.
Experience in applying accounting or cost determination principles, reviewing and analyzing financial and statistical information, preferred.
Experience in state and federal laws and regulations relating to Medicaid reimbursement rates, preferred.
MOS Code:
There are no direct military occupation(s) that relate to the responsibilities, and registration or licensure requirements for this position. All active duty, reservists, guardsmen, and veterans are encouraged to apply if they meet the qualifications for this position.
HHS agencies use E-Verify. You must bring your I-9 documentation with you on your first day of work.
In compliance with the Americans with Disabilities Act (ADA), HHS agencies will provide reasonable accommodation during the hiring and selection process for qualified individuals with a disability. If you need assistance completing the on-line application, contact the HHS Employee Service Center at 1-888-894-4747. If you are contacted for an interview and need accommodation to participate in the interview process, please notify the person scheduling the interview.
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