Business Analyst II (Medicaid Managed Care Encounter Analyst)

Career Opportunities: Business Analyst II (Medicaid Managed Care Encounter Analyst) (21216) Posting ID 21216 -Posted - Health & Human Services Comm - Encounters andFile SuppAndCoor - Business and Financial Operations - c. $5000 - $6999 per month 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: Business Analyst II (Medicaid Managed Care Encounter Analyst) Job Title: Information Technology BA II Agency: Health & Human Services Comm Department: Encounters andFile SuppAndCoor Posting Number: 21216 Closing Date: 09/23/2026 Posting Audience: Internal and External Occupational Category: Business and Financial Operations Salary Range: $5,098.66-$6,701.75 Pay Frequency: Monthly Salary Group: TEXAS-B-23 Shift: Day Additional Shift: None Telework: Travel: Up to 25% Regular/Temporary: Regular Full Time/Part Time: Full time FLSA Exempt/Non-Exempt: Nonexempt Facility Location: Job Location City: AUSTIN Job Location Address: 701 W 51ST ST Other Locations: None MOS Codes: 8846,8848,8858,14NX,15AX,16KX,181X,182X,1D7X1,255A,25B,26B,62E,681X,682X,781X,782X,CYB10,CYB11,ISM IT,Z Prefix Brief Job Description: The Texas Medicaid and CHIP Services (MCS) department is seeking a highly qualified Information Technology Business Analyst II (BA) to join the Encounters and File Support team. This position reports to the Manager of the Encounters and File Support unit within the Business Automation Support area. The work involves managing operational issues related to Medicaid encounters that are records of services delivered to Medicaid and CHIP beneficiaries enrolled in managed care plans and other vendor activities. The Business Analyst performs complex (journey-level) business analysis work to improve the quality of information technology solutions to meet the Medicaid business. The selected individual will perform technical analysis and provide guidance to other agency areas regarding the interpretation of policies and procedures in support of Medicaid Enterprise Systems (MES) functionality including, file support and coordination. The ideal candidate is a self-starter who exercises sound judgment, can work under general supervision, with moderate latitude for the use of initiative and independent judgement. Essential Job Functions (EJFs): (30%) Monitor, assess, and manage data issues related to Medicaid encounters which are records of services delivered to Medicaid and CHIP beneficiaries enrolled in managed care plans. Develop agendas, facilitate workgroup and stakeholder meetings. Coordinate with team members to discuss encounter data and errors. Prepare professional briefings to provide encounter status updates, identify issues and make recommendations.

• 25%) Represent the Encounters unit as a liaison with other areas including Medicaid and CHIP programs, Managed Care Organizations (MCO), Texas Medicaid & Healthcare Partnership (TMHP), Information Technology, and other stakeholder groups. Gather, develop, and document user requirements for the automation of new or improved existing systems to enhance business operations. Monitor and analyze encounter submission errors to identify performance trends and recommend program improvements or contract enhancements. Conduct detailed research and analysis of operational issues, including examining rules, policies, and regulations relating to timely and accurate encounter processing.
• 20%) File support and coordination of operational files supporting Medicaid Enterprise Systems (MES) functionality. Prepare diagrams and flow charts to assist in tracking system interface files.
• 15%) Provide subject matter expertise and technical assistance for readiness reviews related to the Medicaid and CHIP encounter processing and reporting. Ensure compliance to determine whether vendors can deliver services in accordance with the contract terms and requirements.
• 5%) Communicate timely with the supervisor regarding challenging problems and provides recommendations to ensure appropriate action is taken.
• 5%) Performs other duties as assigned by supervisor, including administrative functions and/or serving in a supporting capacity for the Medicaid/CHIP division.

Knowledge, Skills and Abilities (KSAs): Knowledge of: Medicaid or CHIP programs and policies. Techniques used in automated systems. Customer relations principles and practices. Policies and procedures used in managed care, health care, health insurance programs, or health and human services programs. Relationships between agency systems as related to provider enrollment, client eligibility, and claims payment, including the multiple technologies supporting these complex systems. Skill in: Coordinating and solving problems. Communicating effectively both verbally and in writing with technical and non-technical staff. Reviewing technical requirements to ensure vendors are using best practices and technology. Establishing and maintaining effective working relationships. Using personal computer application software such as Microsoft Office (Outlook, Teams, Word, Excel, PowerPoint). Advanced Excel, or similar programs. Ability to: Ensure systems meet business user requirements. Ability to research, evaluate and make recommendations for oversight issues. Ability to gather and analyze information from a variety of sources, including written documentation, numerical data, reports, and other relevant sources, to identify trends, issues, and key findings, and to communicate effectively. Ability to work cooperatively as a team member. Initial Screening Criteria: Bachelor’s degree from an accredited college or university combined with 3+ years of progressively responsible experience in technical leadership, project management, or account management. Prefer degree specialization in a business, technology, or health-related discipline. or At least seven years of relevant professional experience. The seven years must include at least three years of progressively responsible experience leading technical initiatives, managing projects, or managing customer relationships. Experience in systems or business analysis. Experience with health providers, managed care organizations, or external vendors. Preferred experience: Medicaid, CHIP, or Medicaid Managed Care policies Medicaid claims or encounters Agile methodologies or processes Auditing or fiscal monitoring Additional Information: Out-of-state resumes will not be accepted. Selected candidate must be able to work onsite in the Austin office. Job histories must demonstrate how you meet the initial selection criteria at a minimum. Candidates selected for an interview will be given an In-basket exercise. Interviews may be conducted online using Microsoft Teams. Any employment offer is contingent upon available budgeted funds. The offered salary will be determined in accordance with budgetary limits and the HHSC Human Resources compensation policy. Some travel including occasional overnight trips may be needed. 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 tothose 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 View phone number on click.appcast.io. 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. #J-18808-Ljbffr FALL CREEK FARM & NURSERY