Sr Decision Support Specialist - Reimbursement & Policy

The Senior Decision Support Specialist role at The University of Texas MD Anderson Cancer Center supports the Clinical Revenue & Reimbursement function within Clinical Revenue & Reimbursement , focusing on protecting and optimizing institutional revenue through advanced reimbursement analytics. The Senior Decision Support Specialist partners closely with finance, managed care, revenue cycle, technical teams, and operational stakeholders to translate complex reimbursement data into clear, actionable business insights that support organizational decision-making.

MD Anderson Cancer Center is a leading institution focused on cancer care, research, education, and prevention. As part of UT MD Anderson, the Senior Decision Support Specialist plays a critical role in advancing financial sustainability by leading complex reimbursement analyses, guiding automation efforts, and ensuring accurate interpretation of payor policies and regulatory requirements. The Senior Decision Support Specialist serves as a subject matter resource and bridge between technical data environments and business operations.

The ideal candidate for the Senior Decision Support Specialist role brings strong experience in healthcare reimbursement analytics, advanced data management and reporting skills, and a deep understanding of Medicare, Medicaid, Medicare Advantage, and commercial payor environments. This individual demonstrates the ability to lead complex analyses, translate technical findings for non-technical audiences, collaborate across multidisciplinary teams, and develop scalable analytical solutions that support revenue protection and operational excellence.

Minimum $42.31 - Midpoint $52.88 - Maximum $63.46
Work Location: Remote
Typical work schedule: Monday - Friday 8am - 5pm

Why Us?
UT MD Anderson offers the opportunity to contribute directly to the mission of eliminating cancer while supporting professional growth, analytical innovation, and meaningful cross-functional collaboration. This role provides exposure to complex healthcare financial environments, leadership opportunities in institutional initiatives, and the flexibility of remote work while supporting work-life balance.
• Employer-paid medical coverage starting day one for employees working 30+ hours/week, plus optional group dental, vision, life, AD&D, and disability insurance.
• Accruals for PTO and Extended Illness Bank, plus paid holidays, wellness, childcare, and other leave options.
• Tuition Assistance Program after six months of service and access to extensive wellness, fitness, and employee resource groups.
• Defined-benefit pension through the Teachers Retirement System, voluntary retirement plans, and employer-paid life and reduced salary protection programs.

Responsibilities

Technical & Analytical Expertise
• Leverage institutional data repositories and reporting tools to perform advanced analytics and decision support
• Manage data analytics, data management, reporting, and visualization using complex formulas and designs
• Utilize SAP Webi Universes to analyze claims, utilization, financial impact, and denial trends
• Apply advanced Microsoft Excel skills using complex formulas and analytical tools
• Ensure analytical deliverables reflect high attention to detail, clear presentation, and actionable insights

Reimbursement, Coverage & Financial Analysis
• Lead complex qualitative and quantitative analyses supporting revenue cycle, reimbursement, and managed care functions
• Conduct in-depth analyses of reimbursement performance, payor trends, denials, and regulatory impacts
• Identify root causes and improvement opportunities related to reimbursement and coverage
• Assess medical coverage for new and existing services and interpret financial impact to the institution
• Support adherence to payor policies and proactive management of non-covered service denials

Automation & Reporting Solutions
• Design and implement automation opportunities to improve reporting efficiency, scalability, accuracy, and timeliness
• Translate business requirements into repeatable, automated analytics and dashboards
• Establish monitoring processes and data validation checkpoints to ensure automation reliability
• Develop scalable, self-service analytic tools to support data-driven decision-making

Collaboration & Customer Engagement
• Lead institutional workgroups and committees related to reimbursement and financial performance
• Manage internal customer relationships through regular meetings, documentation, and timely delivery
• Collaborate with IT, Revenue Cycle, Payor Strategies, and clinical operations to optimize workflows
• Communicate analytical findings clearly to non-technical audiences and leadership
• Lead cross-functional training and knowledge-sharing initiatives

Documentation & Continuous Improvement
• Develop and maintain internal documentation, workflows, and best practice guides
• Monitor revenue opportunities, corrective actions, risk areas, and cost-saving initiatives
• Continuously improve reimbursement and coverage analytics processes and tools

EDUCATION

Required: Bachelor's Degree Business Administration, Hospital Administration, Finance, Statistics, Economics, Industrial Engineering, Information Services, or other related field.

Preferred: Master's degree in Business Administration, Healthcare Management, Hospital Administration, Finance, Statistics, Economics, Industrial Engineering, Information Services or other related fields.


Advanced coursework or certification in Healthcare Analytics, Data Science, or Revenue Cycle Management is desirable.

WORK EXPERIENCE

Required: 8 years Experience in revenue cycle, finance, accounting, business, economics, reimbursement, patient care, or decision support in a hospital, managed care company, Medicare intermediary, or accounting/consulting firm.

Preferred: 8 years of experience in reimbursement, managed care, Medicare intermediary, consulting, decision support, and/or revenue cycle analytics. Experience in automation and building dashboards a plus.

LICENSES AND CERTIFICATIONS

Preferred: RN, RHIA or comparable clinical or coding certifications. Contract Management, Revenue Integrity, or Healthcare Finance certification (e.g., HFMA CHFP, CRCR) preferred.

Preferred: CPA - Certified Public Accountant American Institute of Certified Public Accountants. Upon Hire

The University of Texas MD Anderson Cancer Center offers excellent benefits, including medical, dental, paid time off, retirement, tuition benefits, educational opportunities, and individual and team recognition.

This position may be responsible for maintaining the security and integrity of critical infrastructure, as defined in Section 113.001(2) of the Texas Business and Commerce Code and therefore may require routine reviews and screening. The ability to satisfy and maintain all requirements necessary to ensure the continued security and integrity of such infrastructure is a condition of hire and continued employment.

It is the policy of The University of Texas MD Anderson Cancer Center to provide equal employment opportunity without regard to race, color, religion, age, national origin, sex, gender, sexual orientation, gender identity/expression, disability, protected veteran status, genetic information, or any other basis protected by institutional policy or by federal, state, or local laws unless such distinction is required by law.