Reimbursement Analyst II

Reimbursement Analyst II

• Reimbursement Analyst II (RA II) reports to the Supervisor of the Department of Family and Protective Services (DFPS) Rates Team within Long-Term Services and Supports (LTSS) section of the Provider Finance Department (PFD) and performs advanced (senior-level) rate analysis work on reimbursement payment rates. Work includes development and implementation of policy and financial analysis to determine and evaluate payment rates for various settings and programs within regular fee review cycle as well as based on changes in programmatic activity.
• RA II plans, develops, and presents recommendations and reports and works under minimal supervision, with extensive latitude for the use of initiative and independent judgement.
• RA II will serve as a senior analyst and subject matter expert in LTSS DFPS Rates Team.

Essential Job Functions:

1.Support development and implementation of policy and financial analysis to determine and evaluate payment rates for various long-term care programs and services. Develops, implements, and maintains rate methodologies and rate calculations. Work includes preparing ad hoc financial analyses and fiscal estimates.

2.Supports the design and study of special cost, statistical research, cost surveys and analysis to evaluate the feasibility and cost implications regarding payment structure options, new program initiatives, and new regulations. Contributes to cost report or cost surveys to support rate methodology or programmatic changes. Interprets analysis results and develops recommendations for internal and external audiences.

3.Supports rate and rule adoption activities, including preparing memorandums and white papers for Executive Leadership, drafting and reviewing of documents to ensure federal approval and authorization in a timely manner as necessary. Develops and processes policy documents relating to payment rate and methodology determination, including state administrative rules, state plan amendments, waiver amendments, etc.

4.Communicates and interfaces with internal and external parties to provide guidance and resolve problems concerning reimbursement rates or payments; rate methodology; rate determination and policy, guidelines, and rule requirements. Provides guidance to PFD LTSS staff on analytical methods used in support of rate methodologies and/or projects.

Assists in hiring, mentoring, and training of junior staff. Serves as a subject matter expert of 24 Hour Residential Child Care reimbursement methodologies, models, data, policies and procedures.

5.Actively contributes to the continuous improvement of department processes though ongoing initiatives including: solutions to automate; building efficiencies; maintaining consistency across multiple calculations, models, and rules, promoting reliable analysis techniques and methods. Creates and updates policies and procedures for documenting internal processes and resources, including standard forms and templates. Knowledge Skills Abilities:

Knowledge of Texas 24 Hour Residential Child Care reimbursement policy and rules is preferred.

Knowledge of methods of quantitative and qualitative analysis, principles, techniques, preferred.

Ability to analyze or evaluate data, calculations and findings, including expertise using Microsoft Excel or statistical software.

Ability to establish and maintain effective work relationships in a team setting.

Ability to communicate effectively in writing, in speaking, and non-verbally.

Ability to communicate complex information to various audiences.

Self-starter while working well in a strong team environment.

Knowledge of principles for calculating fiscal estimates is preferred.

Knowledge of reimbursement rate development is preferred.

Experience of working with MS Excel, MS Word, SQL is preferred. Registration or Licensure Requirements:

Initial Selection Criteria:

Graduation from a four-year college or university with major coursework in accounting, business administration, finance, economics, statistics, or a related field is required.

Experience in developing, compiling, analyzing, and interpreting statistical data for reimbursement analysis, preferred.

Experience with financial analysis, preferred.

Experience with policy analysis, preferred.

Knowledge of database query development is preferred.

Experience of working with MS Excel, MS Word, SQL is preferred. Additional Information:

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.

I-9 Form - Click here to download the I-9 form.

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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