Reimbursement Analyst II – 583535
Texas Health & Human Services Commission
| The Reimbursement Analyst II performs advanced, senior-level coordination, implementation, and technical assistance work related to Texas Medicaid supplemental and directed payment programs under the supervision of Director of Long-Term Services and Supports (LTSS) in the Provider Finance Department. As a member of the LTSS Calculations and Analysis Team, the Reimbursement Analyst II is responsible for the following duties: • Provides high-level program oversight, including activities supporting program administration and implementation including project planning, organization and guidance to program staff; • Conducts complex calculations and analysis to determine and evaluate program eligibility, funding and payments for participating facilities; • Interprets and ensures compliance with any policies, procedures, Texas Administrative Code (TAC), and state and federal statutes and/or policy guidance related to the program, and takes corrective action(s) as needed; • Consults with program participants and external and internal stakeholders, including other agency staff, provider associations, workgroups, advisory committees, legislative staff, client advocates, attorneys, state and federal auditors, and interested parties; conducts program trainings; drafts program policy documents. • Works under limited supervision with considerable latitude for the use of initiative and independent judgment; identifies areas for program improvement. |
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| Essential Job Functions: 1. DEVELOPMENT AND ANALYSIS: Manages the development and implementation of complex data analysis to determine payments for assigned program. Develops, modifies and maintains complex computer programs, spreadsheets and large databases used in rate and/or payment analysis; (35%) 2. PROGRAM OVERSIGHT: Conducts program enrollment, calculates program funding and eligibility, performs quality reviews, tracks program progress, oversees program website content. Provides advanced technical guidance, effective planning, organization and direction to staff in the department to meet internal, legislative, State and/or Federal requirements. Ensures compliance with program policies and procedures, statutes, and rules; and takes corrective action(s) as needed. (30%) 3. STAKEHOLDER AND STAFF COMMUNICATIONS: Interfaces with various 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. Interfaces with external entities including but not limited to: contracted providers, provider representatives, client advocates, other agency staff, advisory committees, workgroups, attorneys and other interested parties concerning NF directed payment program. (20%) 4. DRAFTS DOCUMENTS FOR APPROVAL AND PRESENTATION: 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 (10%) 5. Performs other work assigned or required to maintain and support the office and HHSC operations. (5%) Total: 100% |
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| Knowledge Skills Abilities: • 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 concepts. |
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| Registration or Licensure Requirements: None Required. |
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| Initial Selection Criteria: • Graduation from an accredited 4-year college or university. Experience within Provider Finance 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, finance, and/or statistical applications, preferred. • Experience in using word processing, spreadsheet, statistical and other software, preferred. |
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| Additional Information: Requisition Number 583535 |
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| 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. |
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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. Apply here: https://jobshrportal.hhsc.state.tx.us/ENG/careerportal/Job_Profile.cfm?szOrderID=583535 |