Job Information
HEALTH AND HUMAN SERVICES COMMISSION Reimbursement Analyst I in Austin, Texas
Job/Position DescriptionReimbursement Analyst I position preforms cost analysis related to Medicaid and non-Medicaid payment rate calculation under the supervision of Manger of Calculations and Analysis within Long Term Services and Supports (LTSS) section in the Provider Finance Department. The position provides advanced technical work in the development of payment rates for Medicaid and other programs, processes reconciliations of cost reports for the Attendant Compensation and Direct Care Rate Enhancement programs, processes informal review requests, and performs other prospective and retrospective rate calculations. This position may also provide advanced technical work in the Quality Incentive Payment Program and 24 Hour Residential Child Care and Supervised Independent Living Program. This position works under limited direction and with considerable latitude for the use of initiative and independent judgment. Essential Job Functions1.Development and Analysis: Develops, modifies and maintains complex computer programs, spreadsheets and large databases used in payment rate analyses. Develops and implements data analyses to determine payment rates for various Medicaid and non-Medicaid programs. Designs and conducts cost and statistical data and analyses to evaluate the feasibility and the cost implications affecting contracted provider operations regarding payment rate structure options, program initiatives or enhancements, special payment rate initiatives and program regulations. Writes and maintain syntax used in rate calculations Assists in evaluating statistical methods and procedures used to obtain data to ensure validity, applicability, efficiency, and accuracy. Assists in identifying and evaluating economic factors related to reimbursement rates and pricing. (35%)2.Cost Report Reconciliation: Conducts cost and accountability report reconciliations necessary to hold providers accountable to spending and other requirements in the Attendant Compensation and Direct Care Rate Enhancement programs; communicates results to providers; conducts informal review requests; manages applicable reporting deadlines; contributes to program enrollment as necessary (35%)3.Policy Documentation: Develops and processes policy documents relating to payment rate and methodology determination. Ensures compliance with established procedures, requirements, laws, and regulations. (15%)4.Stakeholder and Staff Communication: 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. Participates in public meetings and records and summarizes public testimony regarding proposed rates or proposed reimbursements for programs (5%)5.Technical Assistance: Designs cost data collection instruments and detailed instruction manuals. Provides technical assistance related to cost collection, policy guidelines and rule requirements. (5%)6.Performs other work as assigned required to maintain and support the office and HHSC operations. (5%)Total: 100%Registrations, Licensure Requirements or CertificationsNone Required. Knowledge Skills AbilitiesExperience in developing and implementing complex data ana https://jobshrportal.hhsc.state.tx.us/ENG/CareerPortal/job_profile.cfm?szOrderID=590332 Copy the URL in the preceding sentence to an Internet Explorer browser to apply to the job directly through the Texas Health and Human Services Career Portal.