Program Specialist V
3 weeks ago
Program Specialist V - Financial Analyst – Accounts Receivable and Medicare & Medicaid Dual Demonstration (MMP) Program
This position is hybrid – 1 day in the office and 4 days telework, subject to adjustment based on work needs.
The Texas Health and Human Services Commission (HHSC) Medicaid CHIP Services (MCS) division seeks a highly qualified candidate to fill the position of Financial Analyst – Accounts Receivable & MMP Program. MCS is driven by its mission to deliver quality, cost-effective services to Texans. This position makes a significant contribution to MCS’s mission by performing advanced financial analysis and regulatory work. Key responsibilities and tasks include reviewing, analyzing, and evaluating financial data, preparing reports, responding to inquiries and recommending appropriate action to resolve financial and regulatory problems. This position reports to Senior Financial Analyst – Accounts Receivable & MMP Program and has no supervisory responsibility. Works under general supervision with extensive latitude for the use of initiative and independent judgment.
The ideal candidate thrives in an environment that emphasizes teamwork to achieve goals, excellence through high professional standards and personal accountability, curiosity to continuously grow and learn, critical thinking for effective execution, and integrity to do things right even when what is right is not easy.
This position is within the MCS Financial Reporting and Audit Coordination area (FRAC). This position provides support for recovery of acute care, Fee for Service (FFS) Medicaid Provider overpayments (Accounts Receivable – A/R). This entails overseeing financial and operational processes in the recovery of overpayments and escalation of provider bankruptcy cases and OAG collection cases. This position routinely works with other state staff, federal staff and vendors, including but not limited to representatives from HHS Accounting, Medicare-Medicaid Plans (MMPs), Centers for Medicare & Medicaid Services (CMS), Office of the Attorney General (OAG), Office of the Inspector General (OIG), HHS Legal, other Medicaid and CHIP Services areas and vendor partners. This position provides support for Medicare-Medicaid Dual Demonstration program (MMP Program) and reviews, monitors, and analyzes all aspects of the financial reporting of Medicare-Medicaid Plans (MMPs) that are under contract with HHSC. This position performs a rigorous and complex validation and reconciliation of MMP self-reported data.
Essential Job Functions:
Works collaboratively across MCS to identify innovative and effective solutions for clients and staff.
Essential Job Functions:
1.MCS Financial Analyst for A/R processes (60%)
•Develops and implements effective techniques for ensuring Medicaid provider overpayments are recorded, reported, monitored, and collected in accordance with contractual agreements, State and Federal requirements and sound business practices. Ensures compliance with established procedures, requirements, laws, and regulations; completeness of data; and presence of documentation.
•Collaborates with various agencies such as the Office of Inspector General (OIG), the Office of Attorney General (OAG), other departments within HHSC and external stakeholders in recovery process and ensures needs are addressed related to accounts receivable recovery and monitoring activities.
•Collects, organizes, analyzes, and prepares material in response to requests for information and reports by internal and external stakeholders, including leadership, on the status of outstanding and collected ARs. Assists on any special projects related to accounts receivable activities to address legislation, litigation, special report needs, etc. Ad hoc reports with specific information may be requested by various internal and external stakeholders. May be required to give presentations on the information.
•Develops and implements process improvements to address state agency needs related to accounts receivable monitoring. Develops policies and procedures for A/R and contract monitoring activities.
2.MCS Financial Analyst for MMP Program (30%)
•Performs financial review and reconciliation of financial reports submitted by contracted vendors.
•Develops, responds, explains, coordinates financial and related aspects of the program compliance. Implements techniques for evaluating program activities and/or business functions and identifies need for changes.
•Develops policies, procedures, and guidelines; and implements and monitors compliance to ensure vendors are meeting contractual and other state and federal requirements.
3.Special projects, research, analysis, reports, and ad hoc financial assignment (10%)
•Supports the Senior Financial Analyst – A/R & MMP on an as-needed basis and may perform other related duties as assigned.
Job functions may evolve or change as may be warranted. Tasks will fluctuate significantly with respect to contract transitions, MMP contract amendments, legislative mandates, and other aspects. May plan, assign, and/or supervise the work of others.
Knowledge Skills Abilities:
•Ability to work collaboratively across MCS to accomplish objectives.
•A keen attention to detail and the ability to implement creative solutions to problems.
•Able to balance team and individual responsibilities.
•Knowledge of financial and accounting terminology and practices as well as strong problem-solving and analytical capabilities.
•Knowledge of state and federal rules and laws related to the Medicaid and CHIP Programs is a plus. Experience researching and interpreting rules and regulations, especially with respect to contracts, policies, and procedures is a plus.
•Ability to perform well under minimal supervision, to take responsibility and ownership of projects and processes, to learn independently, and to be accurate and thorough.
•
•Strong and clear communication capabilities, both written and verbal. Experience in using PC software, particularly proficiency in MS Excel, Outlook and Word. Experience with MCATS, PEMS, PPM, CRM, OnBase is a plus.
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