Rate Setting Financial Analyst
About The Position
The Department of Health and Human Services (DHHS) is seeking a Rate Setting Financial Analyst for the Office of MaineCare Services (OMS) Data Analytics team. This position is responsible for researching and analyzing cost and financial data to determine appropriate rates and cost charges for services. The analyst will produce updated fee schedules, create fiscal impact analyses for rate changes and legislative bills, and develop rate letters. This role involves providing analysis of reimbursement rates for MaineCare and other Department programs, collaborating with various program staff to develop and implement rate-setting methodologies, and determining the financial impact of proposed reimbursement changes. The position also includes supervising and cross-training other Rate Setting staff, participating in the review and development of rate models and Alternative Payment Methodologies, acting as a subject matter expert on rate models during Rate Reform, and covering meetings for the Manager of Rate Setting.
Requirements
- An eight (8) year combination of education and/or experience comprised of a Master’s Degree in Business Administration, Non-Profit Administration, Finance, or a closely related field and two (2) years of experience in cost, budget, and financial analysis.
- Directly related professional experience may be substituted for education on a year-for-year basis.
- A thorough knowledge of the Governmental Accounting Standards Board’s Generally Accepted Accounting Principles (GASB/GAAP) evidenced through formal education and practical experience at the professional level.
- An established record of managing complex fiscal issues with successful outcomes.
- Ability to successfully partner with financial and program staff to achieve common goals.
- Ability to research law, regulations, and Medicaid policies to provide sound advice and recommendations to executive managers.
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
- Research and analyze cost and financial data from various sources and determine appropriate rates and cost charges for services.
- Produce updated fee schedules on an annual basis, or on an ad hoc basis as rates are updated.
- Create fiscal impact analysis of potential annual rate changes, provider rate requests, and Legislative bills for changes in MaineCare Reimbursement.
- Create rate letters when a reimbursement methodology indicates that provider-specific rates are appropriate.
- Provide DHHS administration with analysis of reimbursement rates associated with MaineCare and other Department programs.
- Work with program staff from OMS Policy, Provider Relations, Care Coordination, Delivery System Reform, and other OMS units, and also from other DHHS Offices, to develop and implement rate-setting methodologies and assumptions used to develop and authorize payments to providers for services delivered to MaineCare members.
- Determine financial impact to the Department regarding proposed changes in reimbursement methods and/or levels.
- Supervise and cross-train other Rate Setting staff.
- Participate in the review and development of rate models and Alternative Payment Methodologies.
- Act as the Department’s subject matter expert on rate models and rate model elements as part of the Rate Reform process.
- Cover meetings when the Manager of Rate Setting is unavailable, acting as a subject matter expert.
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 18.86% 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 for all employees welcoming a child
- Voluntary Deferred Compensation (MaineSaves 457(b) account)
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
