Description
Join the Texas Health and Human Services Commission (HHSC) and be part of a team committed to creating a positive impact in the lives of fellow Texans. At HHSC, your contributions matter, and we support you at each stage of your life and work journey. Our comprehensive benefits package includes 100% paid employee health insurance for full-time eligible employees, a defined benefit pension plan, generous time off benefits, numerous opportunities for career advancement and more. Explore more details on the Benefits of Working at HHS webpage.
Functional Title: Reimbursement Analyst I
Job Title: Reimbursement Analyst I
Agency: Health & Human Services Comm
Department: HHS Provider Finance M/C Admin
Posting Number: 12432
Closing Date: 07/03/2026
Posting Audience: Internal and External
Occupational Category: Business and Financial Operations
Salary Group: TEXAS-B-21
Salary Range: $4,523.16 - $7,253.83
Pay Frequency: Monthly
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
Brief Job Description:
This position is hybrid with (currently) two in-office days per week in Austin. Applicants from outside Texas must be willing to relocate within 30 days of hire.
Reimbursement Analyst I position performs work for the Provider Finance Department under the supervision of the Acute Care Supplemental Payments Team Manager. Performs highly complex (senior-level) rate analysis work of supplemental payment programs. Work includes developing and implementing data analysis to determine and evaluate payment rates; preparing cost surveys, instruments, and instructions; and planning, developing, and presenting recommendations and reports. Works under limited supervision, with considerable latitude for the use of initiative and independent judgment. Duties include managing the payment rate development process including performing independent research and gathering information from multiple data sources; conducting complex data analysis to determine and evaluate Medicaid and other payment rates; summarizing analysis and findings in concise documentation; conducting and/or participating in public rate hearings; and providing timely responses to questions by providers and members of the public.
Develops, modifies, and maintains complex computer programs, spreadsheets and large databases used in payment rate analysis. Develops reimbursement policy guidelines, agency rules, state plan amendments and other associated documents relating to cost reporting and payment rate determination.
Essential Job Functions (EJFs):
Attends work on a regular and predictable schedule in accordance with agency leave policy and performs other duties as assigned.
Financial Modeling – 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. (30%)
Drafting, Publication, and Compliance – 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. (30%)
Coordination – 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. (20%)
Stakeholder Relations – 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. (15%)
Performs other work as assigned or required to maintain and support the office and HHSC operations. (5%)
Knowledge, Skills and Abilities (KSAs):
Knowledge of:
- 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
Skill in:
- 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.
Ability to:
- 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
Registrations, Licensure Requirements or Certifications:
N/A
Initial Screening Criteria:
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.
Additional Information:
N/A
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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.
ADA Accommodations:
In compliance with the Americans with Disabilities Act (ADA), HHSC and DSHS 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.
Pre-Employment Checks and Work Eligibility:
Depending on the program area and position requirements, applicants selected for hire may be required to pass background and other due diligence checks.
HHSC uses E-Verify. You must bring your I-9 documentation with you on your first day of work. Download the I-9 Form
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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