Texas Health and Human Services ยท 4 hours ago
Reimbursement Analyst I
Austin, TX
Contract
Hybrid
New Grad, Entry Level
$4,523.16/mo - $7,253.83/moTexas Health and Human Services Commission (HHSC) is committed to creating a positive impact in the lives of fellow Texans. The Reimbursement Analyst I position involves performing complex rate analysis work for supplemental payment programs, developing data analysis, and preparing reports while working under limited supervision.
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
Works with team members and manager to develop and implement complex data analysis related to supplemental payment programs for acute care services
Conducts special cost and statistical research and analysis to evaluate the feasibility and the cost implications about payment rate structure options, new program initiatives or enhancements, special payment rate initiatives, and new regulations
Develops, modifies, and maintains complex computer programs, spreadsheets, and large databases used in payment rate analysis
Works on monthly deliverables to communicate scorecard information on supplemental payment programs to providers and Medicaid managed care organizations
Responds to questions and requests for information from the Centers for Medicare and Medicaid Services (CMS) as need on programs
Develops and processes reimbursement aspect of policy documents (including policy guidelines, agency rules, state plan amendments, council and advisory committee items, workgroup materials, and hearing other notices) relating payment rate and payment methodology determination
Communicate 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 methodology issues affecting program delivery and payment rate determination
Records and summarizes all forms of public testimony regarding proposed programs
Responds to inquiries and questions from providers, stakeholders or internal staff
Provides information to answer questions, may complete or contribute to legislative analysis, open records requests or other items as needed
Performs trainings for directed or supplemental payment programs as needed
Performs other work as assigned or required to maintain and support the office and HHSC operations
Qualification
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
Experience with Medicaid and/or healthcare finance preferred
Experience with SQL-based data querying software preferred
Advanced Microsoft Office (Excel, Word, PowerPoint), business objects, TMHP Software, claims processing engines, SQL, R, SAS, Python
Data analysis, statistics, and data visualization
Medical claims data, methods of funding, program rules, Medicare, and Medicaid
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
Establishing goals and objectives
The development, implementation, and application of reimbursement methodologies and payment programs
Interpret data and develop effective operating procedures
Work with large datasets efficiently
Organize and present information effectively, both orally and in writing to technical and non-technical audiences
Analyze laws, regulations, program policies, and issues
Establish effective working relationships with staff at all levels of an organization, agencies, providers, and stakeholders
Exercise independent judgment, set priorities, meet deadlines, and adapt to shifting technical and political developments
Preferred
Experience with Medicaid and/or healthcare finance preferred
Experience with SQL-based data querying software preferred
Benefits
100% paid employee health insurance for full-time eligible employees
Defined benefit pension plan
Generous time off benefits
Numerous opportunities for career advancement
Company
Texas Health and Human Services
Texas Health and Human Services is an agency that focuses on improving health, safety and well-being.
Founded in 1907
10001+ employees
Funding
Current Stage
Late StageLeadership Team
Dr. Napoleon Broughton
Chief Executive Officer: Life Enhancement Solutions
John F. Palermo
CTO Strategic Analyst VI
Recent News
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