Research Specialist IV
6 months ago
Research Specialist IV
he Research Specialist IV reports to the Manager of the Research, Development and Methodology Team (RDM) within the Long-Term Services and Supports (LTSS) section of the Provider Finance Department (PFD) and performs complex research and rate setting work, including evaluation of existing, new or alternative rate methodologies for Medicaid and non-Medicaid services. The work involves research of state and federal regulations, analysis of Texas rate setting and reimbursement methodologies, and those used in other states, and general policy research and other research projects as assigned.
The Research Specialist IV will work with LTSS rates and methodologies, including updating pro-forma rate models and performing rate and fiscal estimate calculations. Research and rate setting will be performed under moderate direction with significant latitude for the use of initiative and independent judgment.
The Research Specialist IV also prepares a variety of narrative reports, studies or other deliverables for internal and external audiences containing research results related to the rate setting process. The Research Specialist IV will be expected to make presentations related to research and rate setting work and represent the PFD in meetings with internal and external stakeholders. The Research Specialist IV prepares memorandums and white papers regarding the research and analysis performed for Executive leadership. The Research Specialist IV performs other duties necessary to achieve the mission of the Health and Human Services Commission (HHSC). Essential Job Functions:
EJF 1. Analysis and Development of existing, new and alternative rate methodologies: Performs complex research related to HHSC’s Medicaid and non-Medicaid rate methodologies necessary to develop LTSS reimbursement rates and supplemental payment programs. Contributes to LTSS rate setting work by refining LTSS pro-forma rate models to ensure that they align with State and Federal guidelines and regulations, Texas Administrative Code, and industry’s best practices. Provides consultation and technical advice on research methods and techniques to staff in the department. Reviews, analyzes, and evaluates the impact of legislation, regulations, and policies affecting reimbursement rates and healthcare finance, reports results and makes recommendations to PFD Leadership, Executive staff, including the Executive Commissioner and other key personnel. Develops and monitors long-term research objectives, programs, and priorities needed to develop new reimbursement techniques and to evaluate how reimbursement rates are influencing HHSC’s outcomes goals for clients; communicates to and advises departmental leadership regarding the progress towards the long-term research objectives upon request. (40%)
EJF 2. Draft Documents for Approval and Presentation: Drafts memorandums, white papers, state plan amendments, rule amendments based on analyses, conducts public hearings; prepares independent reports and presentations on analyses results to other staff and department leadership on a routine basis; delivers oral presentations and reports on financial programs and initiatives to various provider and stakeholder organizations and to HHSC leadership; communicates complex results in a manner that can be easily understood by various audiences including public stakeholders. Represents PFD in committees, regional workgroups, and projects to meet research and data analysis needs. Prepares information and reports for professional organizations, stakeholders, federal personnel, other governmental entities, Executive staff, and the public regarding the long-term research objectives and outcomes of that research. (30%)
EJF 3. Promote Improvement and Innovation: Actively contributes to the continuous improvement of department processes through ongoing initiatives including solutions to automate; building efficiencies; maintaining consistency across multiple models and rate calculations. Creates and updates policies and procedures for documenting internal processes and resources. (25%)
EJF 4. Other duties as assigned include but are not limited to actively participating and/or serving in a supporting role to meet the agency’s obligations. (5%) Knowledge Skills Abilities:
Knowledge of research methods, principles, techniques.
Ability to analyze or evaluate research data and findings.
Ability to establish and maintain effective work relationships in a team setting.
Ability to communicate effectively in writing, in speaking, and nonverbally.
Ability to edit narrative reports.
Ability to learn and effectively apply new procedures and techniques.
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