Reimbursement Analyst V (Rate Research and Implementation)

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 (Rate Research and Implementation)

Job Title: Reimbursement Analyst V

Agency: Health & Human Services Comm

Department: HHSC & HHS Rate Analysis LTC

Posting Number: 20308

Closing Date: 10/23/2026

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 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:

Reimbursement Analyst V (RA V) reports to the Manager of the Rate Research and Implementation (RRI) team within the Long-Term Services and Supports (LTSS) section of the Provider Finance Department (PFD) and performs highly advanced (senior-level) rate analysis work on reimbursement payment rates. Work includes overseeing the development, financial evaluation, and implementation of reimbursement methodologies and payment rates for various Medicaid and non-Medicaid long-term care programs within regular biennial fee review cycle as well as based on changes in programmatic activity.

RA V oversees planning, analysis, development, and presentation of recommendations and reports and works under minimal supervision, with extensive latitude for the use of initiative and independent judgement.

RA V serves as a senior analyst and subject matter expert in LTSS rates and methodologies. Under the direction and assistance of the RRI Manager, RA V mentors junior staff, engage in staff training and help to ensure work is completed accurately and meets required deadlines.

Essential job functions (EJFs):

• Oversees the development and implementation of policy and financial analysis to determine and evaluate payment rates for various long-term care programs and services. Oversees the development, implementation and maintenance of rate methodologies and rate calculations. Work includes preparing ad hoc financial analyses and fiscal estimates. (35%)
• Oversees the design and study of special cost, statistical research, cost surveys and analysis to evaluate the feasibility and cost implications regarding payment structure options, new program initiatives, and new regulations. Contributes to cost report or cost surveys to support rate methodology or programmatic changes. Interprets analysis results and develops recommendations for internal and external audiences. (25%)
• Oversees rate and rule adoption activities, including preparing memorandums and white papers for Executive Leadership, drafting and reviewing of documents to ensure federal approval and authorization in a timely manner as necessary. Develops and processes policy documents relating to payment rate and methodology determination, including state administrative rules, state plan amendments, waiver amendments, etc. (25%)
• Communicates and interfaces with internal and external parties to provide guidance and resolve problems concerning reimbursement rates or payments; rate methodology; rate determination and policy, guidelines, and rule requirements. Provides guidance to PFD LTSS staff on analytical methods used in support of rate methodologies and/or projects. Assists in hiring, mentoring, and training of junior staff. Serves as a subject matter expert of LTSS reimbursement methodologies, models, data, policies and procedures. (10%)
• Actively contributes to the continuous improvement of department processes though ongoing initiatives including: solutions to automate; building efficiencies; maintaining consistency across multiple calculations, models, and rules, promoting reliable analysis techniques and methods. Creates and updates policies and procedures for documenting internal processes and resources, including standard forms and templates. (5%)

Knowledge, Skills and abilities (KSAs):

• Knowledge of Texas Medicaid reimbursement policy and rules is preferred.
• Knowledge of methods of quantitative and qualitative analysis, principles, techniques, preferred.
• Ability to analyze or evaluate data, calculations and findings, including expertise using Microsoft Excel or statistical software.
• Ability to establish and maintain effective work relationships in a team setting.
• Ability to communicate effectively in writing, in speaking, and non-verbally.
• Ability to sound independent decisions by applying policies and procedures and using available resources.
• Self-starter while working well in a strong team environment.
• Knowledge of principles for calculating fiscal estimates is preferred.
• Knowledge of reimbursement rate development is preferred.
• Experience of working with MS Excel and MS Word is preferred.

Registrations, Licensure Requirements or Certifications:

N/A.

Initial Selection Criteria:

• Graduation from an accredited four-year college or university required.
• Major coursework in accounting, business administration, finance, economics, statistics, or a related field is preferred. Note: practical experience in these fields may be substituted for major coursework
• At least three years of experience in accounting, Medicaid/Medicare, healthcare business, state government policy, statistics, finance, or other relevant fields.

Additional Information:

Applicants must complete the online application in full and include a clear summary of experience that shows how they meet the initial screening criteria.

Telework flexibility may be available in accordance with agency policy; in-office presence is currently required two days a week but may be modified based on business need.

Occasional travel may be required for meetings, trainings, or stakeholder engagement.

Military occupation specialty (MOS) codes related to this position are available through the Texas State Auditor's Office Military Crosswalk.

Review our Tips for Success when applying for jobs at DFPS, DSHS and HHSC.

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 Auditors 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.