Reimbursement Analyst V

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Functional Title: Reimbursement Analyst V

Job Title: Reimbursement Analyst V Agency: Health & Human Services Department: HHSC & HHS Rate Analysis M/C Posting Number: 13069 Closing Date: 07/22/2026 Posting Audience: Internal and External Occupational Category: Business and Financial Operations Salary Group: TEXAS-B-25 Salary Range: $5,797.66 - $9,508.25 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. The Reimbursement Analyst V (RAV) position reports to the Manager of Acute Care Services Payment Comparison and serves as lead reimbursement analyst for the Acute Care Services Payment Comparison team. This team is responsible for the design, development, and overall compliance of federal payment rate requirements and reporting. Work involves maintaining complex applications, spreadsheets, and databases used in the determination of payment rates and reporting, as well as strategic operations and planning.

Key Responsibilities:

• Maintains complex applications, spreadsheets, and databases used in the determination of payment rates and reporting.
• Conducts executive briefings, interacts and responds to executive staff requests, and responds to inquiries from providers and other staff as required.
• Reviews work products, trains, and mentors other analysts to ensure high quality team outputs.
• Provides guidance for operational and tactical planning, program development, and data analysis and evaluation related to services and issues.
• Establishes goals and objectives, drafts and maintains policies and procedures, and keeps work products on track to meet deadlines.
• Consults on priorities, standards, measurement tools, and reporting systems for determining progress in meeting goals.
• Works under minimal supervision, with extensive latitude for the use of initiative and independent judgment.

Essential Job Functions (EJFs):

• Attends work on a regular and predictable schedule in accordance with agency leave policy and performs other duties as assigned.
• Drafting, Review, and Publishing - Keeps reports, documents, and other deliverables on schedule.
• Completes detailed analysis of payment rates, claims data, and financial data.
• Interprets federal and state statute and regulations to understand applicability and requirements.
• Drafts documents as assigned, reviews work of others for accuracy, creates templates, provides feedback to other analysts and leadership.
• Prepare documents for, meets with and briefs executive staff on proposed initiatives.
• Ensures deliverable and publication dates are met.

(35%)

Coordination and Communication:

• Interfaces with various Provider Finance staff, provider industry representatives, HHS Enterprise staff, federal staff, legal staff, advisory committees, workgroups, contracted providers, provider representatives, client advocates, and other interested parties concerning payment rate policy issues affecting program delivery, reporting, and compliance documents.
• Provides day‑to‑day guidance, mentoring, and technical support to staff on analytical methods, data evaluation, and policy interpretation.

(20%)

Workflow Management:

• Proactively manages workflow to meet all required notices, submission, and publication of state and federal reports, State Plan Amendments (SPA), and Texas Administrative Code (TAC) updates.
• Review work of other analysts to ensure accuracy and quality of work.
• Responds to legislative inquiries, completes bill analysis, drafts and estimates fiscal impacts, meets with legislative staff and/or attends hearings as required.
• Ensures team adherence to established procedures, quality standards, and deliverable timelines.

(20%)

Processes and Procedures:

• Creates, defines, and documents processes and procedures (P&Ps).
• P&Ps should facilitate team consistency, quality, knowledge retention, training, efficiency, and productivity.
• Maintains P&P documents to reflect current-state processes and continuous improvement.
• Ensures team is knowledgeable and complies with P&Ps.

(20%)

Knowledge, Skills and Abilities (KSAs):

• Knowledge of: Advanced Microsoft Office (Excel, Word, PowerPoint), business objects, TMHP Software, claims processing engines, and data querying/analysis tools such as SQL, R, SAS, Python.

• Data analysis, statistics, data visualization, medical claims data, methods of funding, program rules, Medicare, and Medicaid.

• Reimbursement methodologies.

• Texas legislative process.

• Health and human service programs, services, and procedures.

• Data quality and integrity processes.

• Skill in: Managing multiple and competing priorities.

• Identifying problems, evaluating alternatives, and implementing solutions.

• Working collaboratively and cooperatively with diverse groups.

• Communication and public speaking.

• 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.

• Establish goals and objectives.

• Train and provide constructive feedback to staff.

• 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.

Additional Information: N/A

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