Reimbursement Analyst III

Texas Health and Human Services Commission

$61K — $99K *
Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor's degree from an accredited institution or equivalent experience in Provider Finance.
  • Minimum of one year experience in advanced communication, both verbal and written.
  • At least one year experience analyzing large data sets or developing payment rates.
  • Experience interpreting state and federal Medicaid reimbursement laws and regulations is preferred.
  • Demonstrated proficiency in Microsoft Excel for data analysis.

Responsibilities

  • Manage development and analysis of complex data to determine program payments.
  • Oversee implementation and processing of LTSS directed payment programs.
  • Communicate complex information to stakeholders regarding payment programs and eligibility.
  • Draft policies and procedures as a subject matter expert for reimbursement processes.
  • Design data collection instruments for compliance assessments.
  • Coordinate with various parties, including legal staff and advisory committees, to address payment issues.
  • Perform additional duties to ensure program efficiency as assigned.

Benefits

  • Eligible for telework options depending on supervisor discretion.
  • Participation in a dynamic team focusing on improving healthcare reimbursement systems.
  • Opportunities for professional development and growth within the Health & Human Services sector.
  • Work-life balance with standard day shifts and minimal travel requirements.
Full Job Description
Functional Title: Reimbursement Analyst III Job Title: Reimbursement Analyst III Agency: Health & Human Services Comm Department: HHS Provider Finance SHARS Posting Number: 20496 Closing Date: 10/23/2026 Posting Audience: Internal and External Occupational Category: Business and Financial Operations Salary Range: $5,098.66- $8,304.83 Pay Frequency: MonthlySalary Group: TEXAS-B-23 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

The Reimbursement Analyst III performs highly advanced (senior-level) rate analysis work related to reimbursement payment rates, data development, and technical analyses under the supervision of the Manager of Cost Report Based Rate Methodology & Supplemental Payments within the Long-Term Services and Supports (LTSS) section in the Provider Finance Department (PFD).

The position serves as a subject matter expert on assigned payment programs and oversees the LTSS directed payment programs for Nursing Facilities; a supplemental payment program for Intermediate Care Facilities; directed and supplemental payment rate models; and the development, modification and maintenance of complex computer programs, spreadsheets, and large databases.

Essential Job Functions:
  1. DEVELOPMENT AND ANALYSIS (35%): 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.


  1. OVERSIGHT OF PAYMENT PROGRAMS (30%): Oversees development, implementation, and processing for LTSS directed payment programs. Develops and maintains payment rate models used to make accurate and timely payments to program participants. Ensures program procedures and associated processes conform to Texas Administrative Code requirements, and state and federal statutes, rules and guidelines. Designs data collection instruments and detailed instruction manuals to collect eligibility and enrollment data from contracted providers for use determining compliance with applicable Texas Administrative Code requirements, and state and federal statutes, rules and guidelines.


  1. STAKEHOLDER AND STAFF COMMUNICATIONS (20%): 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 directed payment and supplemental payment programs. (20%)


  1. DRAFTS DOCUMENTS FOR APPROVAL AND PRESENTATION (10%): 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.


  1. OTHER DUTIES (5%): Performs other duties as assigned and as required to maintain efficient program and agency operations.


Knowledge, Skills and Abilities:
  • Advanced skill in Microsoft Excel.
  • Skill in developing, implementing, interpreting and evaluating policies, procedures, regulations, and laws.
  • Ability to exercise independent judgment, set priorities, meet deadlines and adapt to shifting technical and political developments.
  • Ability to plan, organize, and coordinate the work of others.
  • Ability to establish goals and objectives, coordinate the achievement of established goals and objectives and identify problems and develop creative solutions.
  • Ability to communicate effectively both orally and in writing with a variety of agency staff, medical/provider associations, legislative staff, lawyers, state/federal auditors, and interested parties on Medicaid reimbursement issues.


Initial Screening 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.

At least one year of experience in advanced written and verbal communication and one year of experience working with large amounts of data, developing payment rates, 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 in the development, implementation, and maintenance of supplemental payment programs 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.

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