Reimbursement Analyst V

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 V
Job Title: Reimbursement Analyst V
Agency: Health & Human Services Comm
Department: HHSC & HHS Rate Analysis M/C
Posting Number: 20551
Closing Date: 02/23/2027
Posting Audience: Internal and External
Occupational Category: Business and Financial Operations
Salary Range: $5,797.66- $9,508.25
Pay Frequency: Monthly
Salary Group: TEXAS-B-25
Shift: Day
Additional Shift:
Telework: Eligible for Telework
Travel: Up to 15%
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 works on Acute Care and Hospital related program for the Provider Finance Department. Work involves maintaining complex applications, spreadsheets, and databases used in the determination of payment rates and reporting, as well as strategic operations and planning. The RAV generates and summarizes written documentation to comply with state and federal rules and regulations, conducts executive briefings, interacts and responds to executive staff requests, and responds to inquiries from providers and other staff as required. Provides guidance for operational and technical planning, program development, and data analysis and evaluation related to services and issues. Work involves establishing goals and objectives, drafting and maintaining policies and procedures, and keeping work products on track to meet deadlines; consulting 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.

Develops and implements complex data analysis to determine payment rates for the Acute Care and Hospital finance related programs. Designs and 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%)

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 various contracted providers, provider representatives, client advocates, other agency staff, advisory committees, workgroups, attorneys, and other interested parties concerning Acute Care and Hospital related programs. Sends state action requests to implement rates for new benefits or for updates. (25%)

Proactively manage 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. Respond to legislative inquiries, complete bill analysis, draft and estimate fiscal impacts, meet with legislative staff and/or attend hearings as required. Ensures team adherence to established procedures, quality standards, and deliverable timelines. (20%)

Create, define, and document processes and procedures (P&Ps). P&Ps should facilitate team consistency, quality, knowledge retention, training, efficiency, and productivity. Maintain P&P documents to reflect current-state processes and continuous improvement. Ensure team is knowledgeable and comply with P&Ps. (20%)

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, 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.

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.

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.

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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 View phone number on aiapply.co. 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.