Rate Setting Data Specialist
About The Position
The Rate Setting Data Specialist assists in research, data collection, data analysis, document creation, coordination, and task tracking. The primary function of this position would be to assist and provide support to the Rate Setting Financial Analysts and broader Data Analytics team. This includes researching reimbursement rates for MaineCare as well as healthcare reimbursement rates from other State Medicaid Agencies, Medicare, and Commercial Insurance calculations. Additionally, this position would assist in Quality Assurance for all documents that are created both internal and external facing for accuracy.
Requirements
- An eight (8) year combination of education and/or experience analyzing, evaluating, and/or presenting data findings to aid in meeting organizational objectives and informing leadership during decision-making.
- Proficiency with Microsoft Word and Microsoft Excel.
- Data analysis skills and the utilization of critical thinking skills when evaluating data sets.
- Ability to process data to form an analysis and describe and discuss that analysis clearly.
- A history of showing curiosity and a desire to learn new topics thoroughly.
- An established history of working in a team-focused environment.
Nice To Haves
- Experience with and knowledge of the Medicaid program and/or other health and human services programs serving low-income populations
- Lived experience with Medicaid and/or other health-related social needs common to individuals and families receiving Medicaid coverage
Responsibilities
- Collect data publications used in the rate methodologies implemented by the Department including CMS fee schedules in which some MaineCare rates are benchmarked.
- Perform data collection, data extraction, and data analysis of healthcare rates and reimbursement.
- Create fee schedule documents to be posted on the Provider Portal for reference.
- Create and maintain historic data files related to reimbursement rates and changes to those reimbursement rates.
- Provide Quality Assurance review of documents to help ensure the quality of the documents produced.
- Help maintain Quality Assurance protocols and checklists.
- Create letters of reimbursement for special agreements with providers to provide certain services.
- Create informational dashboards based on healthcare data to inform of trends and decision making.
Benefits
- 13 paid holidays
- 3+ weeks of vacation leave annually
- 12 days of sick leave per year
- Health Insurance Coverage (State pays 85%-95% of employee-only premiums)
- Health Insurance Premium Credit (Participation decreases employee-only premiums by 5%)
- Dental Insurance (State pays 100% of employee-only dental premiums)
- Retirement Plan (State contributes 14.06% of employee's pay towards MainePERS)
- Gym Membership Reimbursement (up to $40 per month)
- Health and Dependent Care Flexible Spending Accounts
- Public Service Student Loan Forgiveness eligibility
- Living Resources Program (employee assistance program)
- Six weeks of fully paid parental leave
- Voluntary Deferred Compensation (MaineSaves 457(b) account)
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
Associate degree
