RAV (Cost Report Based Rate Methodology Team)

Texas Health and Human Services Commission

$69K — $114K *
Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor's degree in accounting, finance, business administration, economics, statistics, or related field.
  • 3+ years of experience in reimbursement rate analysis or financial analysis.
  • Experience with Medicaid reimbursement rate regulations preferred.
  • Strong analytical skills for dealing with complex data sets.
  • Advanced proficiency in Microsoft Excel and Word, including document formatting and data manipulation.

Responsibilities

  • Lead establishment and maintenance of reimbursement rate methodologies.
  • Develop and analyze reports and surveys for Medicaid and non-Medicaid programs.
  • Conduct feasibility research and cost analysis for new initiatives.
  • Communicate complex reimbursement issues clearly to stakeholders.
  • Collaborate with internal and external partners to implement process improvements.

Benefits

  • Eligible for telework opportunities.
  • Flexible work environment.
  • Opportunity to work in a supportive team atmosphere.
  • Professional development opportunities available.
  • Engage in meaningful work that impacts community health services.
Full Job Description
Functional Title: RAV (Cost Report Based Rate Methodology Team) Job Title: Reimbursement Analyst V Agency: Health & Human Services Comm Department: HHSC & HHS Rate Analysis M/C Posting Number: 20515 Closing Date: 09/24/2026 Posting Audience: Internal and External Occupational Category: Business and Financial Operations Salary Range: $5,797.66- $9,508.25 Pay Frequency: MonthlySalary Group: TEXAS-B-25 Shift: Day Additional Shift: Telework: Eligible for Telework Travel: Up to 5% Regular/Temporary: Regular Full Time/Part Time: Full time FLSA Exempt/Non-Exempt: Exempt Facility Location:Job Location City: AUSTIN Job Location Address: 4601 W GUADALUPE ST Other Locations: MOS Codes: No military equivalent

JOB DESCRIPTION:

The Reimbursement Analyst V position serves as a member of the Texas Health and Human Services Commission (HHSC) Provider Finance Department (PFD) Long-term Services and Supports (LTSS) team and performs rate analysis and rate setting work.

The position entails highly advanced (senior-level) technical work that includes: establishing and maintaining reimbursement rate methodologies; developing and maintaining report and survey templates to collect financial and statistical data; analyzing cost report, financial, and statistical data; and calculating methodological and proposed rates and fiscal estimates for cost report-based rate methodologies.

This position works under minimal supervision with extensive latitude for the use of initiative, prioritizing assigned tasks, and independent judgment.

ESSENTIAL JOB FUNCTIONS (EJF):

Performs Rate Setting Functions (30%): Leads the establishment and maintenance of rate models, cost reports and surveys, and analysis of financial and statistical data to support cost report-based reimbursement rate methodologies in accordance with Texas Administrative Code rules, program guidelines, and established processes and procedures. Leads the calculation of methodological and proposed rates and fiscal estimates for cost report-based rate methodologies. Coordinates among teammates to analyze processes and develop process improvements.

Report and Survey Development and Analysis (25%): Coordinates with internal colleagues and external stakeholders in the design and maintenance/updates of cost and financial compliance reports or surveys of Medicaid and non-Medicaid programs to inform cost analysis and rate setting efforts. Develops and implements data analysis using standard statistical tools, methods, and techniques. Interprets data analysis results to identify trends and outliers in the data set.

Evaluate and Implements New Initiatives (20%): Coordinates the design and conducts special cost and statistical research and analysis to evaluate the feasibility and cost implications regarding payment rate structure options, new program initiatives or enhancements, special payment rate initiatives, and new regulations. Prepares and presents recommendations and responses for proposed legislation and state or federal initiatives. Prepares reports, memos, Texas Administrative Code Rule amendments, State Plan amendments, waiver amendments, and other documentation to propose and implement new initiatives.

Stakeholder and Staff Communication (20%): 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 LTSS cost report-based reimbursement rate methodologies.

Other Duties as Assigned (5%): Performs other work as assigned required to maintain and support the office and HHSC operations.
Total: 100%

LICENSURE, CERTIFICATION, OR REGISTRATION REQUIRED:

None Required.

KNOWLEDGE, SKILLS, AND ABILITIES REQUIRED:

Knowledge of:
  • LTSS cost reporting and financial examination or auditing practices.
  • The Texas Legislative process.
  • Microsoft Word at an advanced level and the use of HHS accessible templates. (Use of Styles to format documents, Table Styles, HHS Reports tab to create and format reports, page and section breaks to format long documents with different page styles, embedding documents, and able to create accessible documents).
  • Microsoft Excel at an advanced level. (Set up footers, headers, align margins, sort and filter, conditional formatting, use of excel formulas, insert links, concatenation, able to convert to accessible Adobe Acrobat format).
  • Knowledge of database query development and Structured Query Language (SQL)

Skill in:
  • Strong analytical skills with the ability to collect, analyze, organize, and communicate significant amounts of complex information with attention to detail, accuracy, professionalism, and diplomacy.
  • Strong critical thinking skills with the ability to evaluate and implement effective alternative solutions.
  • Interpersonal relationships, teamwork, and establishing and maintaining effective working relationships with people at various levels of expertise.
  • Communicating clearly and concisely, both verbally and in writing with attention to detail.
  • Microsoft Office Suite products (MS Word, Excel, PowerPoint, Outlook, SharePoint, Visio, and others).
  • Structured Query Language (SQL)

Ability to:
  • Perform and interpret numerical analyses to analyze, evaluate, and summarize financial and management records for accuracy and conformance to procedures, rules, and regulations.
  • Collaborate and work well with others with professionalism and diplomacy.
  • Exercise initiative, discretion, and good judgment.
  • Work under limited supervision, exercise independent judgment, set priorities, meet deadlines and adapt to shifting technical and work environmental developments.
  • Manage projects effectively and produce quality work within expected deadlines.
  • Maintain accurate, detailed, and organized documentation of assignments and projects.

INITIAL SCREENING 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 Provider Finance or applicable organization may be substituted for education on a one-to-one basis.

At least three years of experience in reimbursement rate analysis, data analysis, financial analysis, Medicaid, cost reporting processes, or conducting complex cost analyses.

At least one year of experience in interpreting state and federal laws and regulations relating to Medicaid reimbursement rates or cost reporting processes preferred.

Review our Tips for Success when applying for jobs at DFPS, DSHS and HHSC.

Active Duty, Military, Reservists, Guardsmen, and Veterans:

Military occupation(s) that relate to the initial selection criteria and registration or licensure requirements for this position may include, but not limited to those listed in this posting. All active-duty military, reservists, guardsmen, and veterans are encouraged to apply if qualified to fill this position. For more information please see the Texas State Auditor's Job Descriptions, Military Crosswalk and Military Crosswalk Guide at Texas State Auditor's Office - Job Descriptions.

Telework Disclaimer:

This position may be eligible for telework. Please note, all HHS positions are subject to state and agency telework policies in addition to the discretion of the direct supervisor and business needs.

Similar Jobs

More Jobs at Texas Health and Human Services Commission

More Healthcare Jobs

Find similar RAV (Cost Report Based Rate Methodology Team) jobs: