Senior Health Care Management System Analyst/Trainee 1

4 days ago

Albany, New York, United States New York State Civil Service Full time
Job Summary

This position is part of the NYS HELPS program, which aims to promote financial sustainability for healthcare providers. The successful candidate will work as an analyst within the Division of Finance and Rate Setting, within the Bureau of Financially Distressed Hospitals (FDH). The primary goal of the Bureau is to improve health service quality, preserve access, and decrease statewide provider reliance on State aid to fund operations.

Key Responsibilities
  • Reviews financial information accompanying contracts, construction applications, reports, and other operational documents for financial feasibility and impact on Medicaid reimbursement rates.
  • Develops and reviews cost reports, including CFRs, for State-operated programs.
  • Tracks and ensures that reports are filed timely, conducts cost data or desk audits to ensure accuracy of filings, and follows-up on late reports.
  • Reviews budget proposals for programs, contracts, grants, and solicitations for consistency with financial requirements.
  • Ensures quarterly statistical and ancillary financial information is accurately reported, identifies and addresses deficiencies, determines impact of incorrect reporting, and communicates requirements to health care providers.
  • Reviews billing processes or assists with reviews to determine compliance with rules, identifies and implements billing system edits and process changes in conjunction with information technology staff.
  • Consults with agency audit staff on accounting issues requiring comprehensive review.
  • Performs financial and statistical analysis of health care financing methodologies to assess viability.
  • Reviews statutory and regulatory requirements and amendments and assesses their impact on existing health care financing systems and models.
  • Drafts reports documenting impacts and required system billing changes.
  • Researches new health care financing methods to determine viability and reviews existing methods to assess effectiveness and modification possibilities.
  • Conducts financial feasibility studies of health care provider capital projects and financial agreements.
  • Analyzes financial documents and assesses need and availability of capital, operating costs, revenues, and other considerations.
  • Reviews proposals for consistency with operating plans, expansion criteria, sound fiscal practices, character and competence of operator, and overall fiscal viability and cost effectiveness of proposals.
  • Provides technical assistance to budget and fiscal management, treatment, field office, and/or local government staff in the monitoring of health care provider revenues, fiscal planning needs, claiming, and cost reports.
  • Oversees financial databases for assigned program areas.
  • Performs Medicaid rate setting activities.
  • Calculates and updates Medicaid reimbursement rates by reviewing and analyzing relevant information consistent with applicable laws, rules, and regulations.
  • Reviews and analyses requests for rate adjustments and appeals.
  • Assists upper-level Health Care Fiscal Analysts and other staff in developing specialty rates.
  • Resolves health care provider audit and rate appeal issues.
  • Develops necessary information and analyses to resolve outstanding financial issues.
  • Communicates verbally and in writing with providers regarding reimbursement rate adjustments.
  • Resolves questions raised by health care providers and outside auditors relative to assigned reimbursement rates.
  • Reviews audit reports from the Office of the Medicaid Inspector General and other entities to determine impact on assigned health care providers and any changes to reimbursement rates or systems.
  • Reviews rate appeals from health care providers to determine merits and responds in writing to providers regarding appeal outcomes.
  • Communicates with outside audit firms to provide required information and reviews findings to determine impact on assigned programs.
Requirements

This position requires a bachelor's degree in accounting, auditing, business administration, economics, finance, healthcare administration, hospital administration, or public administration, including or supplemented by 12 semester credit hours in accounting and/or auditing and 6 semester additional credit hours in statistics, economics, accounting and/or auditing. Professional experience in the review and analysis of fiscal and cost operations and/or billing systems of a hospital or healthcare facility related to reimbursement rates, principles, and practices is also required.

Preferred qualifications include critical thinking skills, analytical skills with Microsoft Excel, and the ability to solve problems independently. Professional work experience and/or education in accounting and trend analyses are also desirable.

What We Offer

This position offers a competitive salary, a generous benefits package, and a work-life balance. The annual salary is the hiring rate (beginning of the Salary Range) of the position. Promotion salaries are calculated by the NYS Office of the State Comptroller in accordance with NYS Civil Service Law, OSC Payroll rules and regulations, and negotiated union contracts.

The NYS Department of Health is committed to making New York a safer, healthier, and more equitable place to live. Understanding health equity, social determinants of health, and health disparities is critical to accomplishing our goal of eliminating health disparities.

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