North Carolina
**Agency**Dept of Health and Human Services**Division**HEALTH BENEFITS**Job Classification Title**Financial Analyst II (NS)**Position Number**60042633**Grade**NC15The North Carolina Department of Health and Human Services (DHHS) is one of the largest, most complex agencies in the state, and has approximately 17,000 employees. It is responsible for ensuring the health, safety, and well-being of all North Carolinians, providing human service needs for special populations including individuals who are deaf, blind, developmentally disabled, and mentally ill, and helping poor North Carolinians achieve economic independence.**Description of Work**The Provider Audit team is responsible for administering state-directed payment programs, including the Healthcare Access Stabilization Program, Disproportionate Share Hospital Program, Graduate Medical Education Program, and Hospital Upper Payment Limit payments. State-directed payments are calculated quarterly, and models are updated with every payment cycle.
Primary Duties:
\* Serve as the Technical Specialist for State Directed Payments to support the design, implementation, evaluation and compliance monitoring of Medicaid managed care payment arrangement.
\* Ensure that the SDPs align with federal regulations under 42 CFR β 438.6 (c) and meet Center of Medicare and Medicaid Services requirement for transparency, quality, and fiscal integrity.
\* Communicate with and ensuring all data has been furnished in a timely fashion to update the model; this includes all supporting provider schedules, cost reports and attestations and other information deemed necessary to perform calculation of state directed payments.
\* Assist outside requestors under the Freedom of Information Act; this includes assisting Medicaid Fraud Investigators, pulling files for copying, retrieving files from archives, etc.
\* Serve as DHB program manager to maintain complex annual and quarterly model to calculate all necessary hospital assessments (provider tax) and intergovernmental transfers (IGT) receipts which support base rates, Graduate Medical Education (GME) payments, 42 CFR 483.6 approved separate directed payments for hospitals, and Medicaid Expansion.
\* Compile all data and schedules necessary to build the annual payment models and reviews for accuracy, changes, and compliance with federal and state legislation and regulatory requirements and CMS approved Managed Care Preprints.
\* Coordinate with all stakeholders and executes the timing, invoicing and collection of all quarterly/ annual hospitals receivables based on these models, and tracking receipts through to completion and following up on any missing / delayed payments pursuant to legislative authority.
\* Coordinates with all stakeholders and executes the timing of outgoing GME payments to hospitals and separate directed payments through managed care entities to hospitals.
\* Audit Support Assist Auditors (State & Independent) with the annual review of DSH, GME, UPL, and Hospital Directed Payments by providing support documentation and explanation of the models.
\* Assemble audit identified materials after the completion of the final payment for each model year.**Knowledge Skills and Abilities/Management Preferences****Salary Grade Range $53,164 - $93,038**
**Recruitment Range** **$53,164 - $70,000****\*\*Position is eligible for a hybrid-teleworking schedule to include weekly onsite work hours\*\*****Knowledge Skills and Abilities/Management Preferences**Candidates now meet the minimum qualifications of a position if they meet the minimum education and experience listed on the vacancy announcement.The Knowledge, Skills, and Abilities (KSAs)/ Management Preferences are not required. Applicants who possess the following skills are preferred:* Experience working with large workbooks* Experience creating formulas in MS Excel**This position will close at 11:59 p.m. the night before the end date.****This Position Is Funded in Part Through Federal Funds****About the NC Division of Health Benefits:**
**The Division of Health Benefits (DHB)** within NCDHHS is committed to advancing innovative solutions that improve health, promote well-being and foster independence for all North Carolinians. DHB manages and oversees North Carolina Medicaid and other programs that provide access to services and supports for parents, children, seniors, people with intellectual / developmental disabilities, and behavioral health, substance use and traumatic brain injury disorders. With a budget over $27 billion in state and federal funds per fiscal year, DHB ensures that more than 108,000 enrolled providers are reimbursed for delivering covered services to 3.1 million beneficiaries.**Compensation & Benefits:**
The State of North Carolina offers excellent comprehensive benefits.
Employees can participate in health insurance options, standard and supplemental retirement plans, and the NCFlex program (numerous high-quality, low-cost benefits on a pre-tax basis).
Employees also receive paid vacation, sick, and community service leave.
In addition, paid parental leave is available to eligible employees.
Visit website for## **Supplemental and Contact Information**## The North Carolina Department of Health and Human Services (DHHS) is an Equal Opportunity Employer that embraces an Employment First philosophy, which consists of complying with all federal laws, state laws, and Executive Orders.
We are committed to reviewing requests for reasonable accommodation at any time during the hiring process or while on the job.
For more information about DHHS: .DHHS uses the Merit-Based Recruitment and Selection Plan to fill positions subject to the State Human Resources Act with the most qualified individuals.
Hiring salary will be based on relevant qualifications, internal equity, and budgetary considerations pertinent to the advertised position.In accordance with the Governor’s , our agency supports second-chance employment for individuals who were previously incarcerated or justice-involved.
We invite all potential applicants to apply for positions for which they may be qualified.
Application Process
**Be sure to complete the application in its entirety.** *Resumes will not be accepted in lieu of completing this application.** Information should be provided in the appropriate areas, to include the following: Education, including high school and all degrees obtained, Work Experience, and Certificates & Licenses. It is critical to our screening and salary determination process that applications contain comprehensive candidate information.* Answers to Supplemental Questions are not a substitute for providing all relevant information within the body of your application. To receive credit for the supplemental questions, you must provide supporting information within the "Work Experience" section of the application to support your answers.* If multiple applications are submitted to an individual posting, only the most recent application received prior to the closing date will be accepted. Applications must be submitted by 11:59 PM on the closing date.* Applicants may be subject to a criminal background check. All candidates selected for positions considered "Positions of Trust" will be subject to a criminal background check.* Due to the volume of applications received, we are unable to provide information regarding the status of your application over the phone. To check the status of your application, please log in to your account.
Upon the closing date, applications are "Under Review" and will be screened by Human Resources for qualified applicants. The hiring process may take several weeks.* Degrees must be received from appropriately accredited institutions.
Transcripts and degree evaluations may be uploaded with your application. The State of North Carolina/Office of State Human Resources #J-18808-Ljbffr
Primary Duties:
\* Serve as the Technical Specialist for State Directed Payments to support the design, implementation, evaluation and compliance monitoring of Medicaid managed care payment arrangement.
\* Ensure that the SDPs align with federal regulations under 42 CFR β 438.6 (c) and meet Center of Medicare and Medicaid Services requirement for transparency, quality, and fiscal integrity.
\* Communicate with and ensuring all data has been furnished in a timely fashion to update the model; this includes all supporting provider schedules, cost reports and attestations and other information deemed necessary to perform calculation of state directed payments.
\* Assist outside requestors under the Freedom of Information Act; this includes assisting Medicaid Fraud Investigators, pulling files for copying, retrieving files from archives, etc.
\* Serve as DHB program manager to maintain complex annual and quarterly model to calculate all necessary hospital assessments (provider tax) and intergovernmental transfers (IGT) receipts which support base rates, Graduate Medical Education (GME) payments, 42 CFR 483.6 approved separate directed payments for hospitals, and Medicaid Expansion.
\* Compile all data and schedules necessary to build the annual payment models and reviews for accuracy, changes, and compliance with federal and state legislation and regulatory requirements and CMS approved Managed Care Preprints.
\* Coordinate with all stakeholders and executes the timing, invoicing and collection of all quarterly/ annual hospitals receivables based on these models, and tracking receipts through to completion and following up on any missing / delayed payments pursuant to legislative authority.
\* Coordinates with all stakeholders and executes the timing of outgoing GME payments to hospitals and separate directed payments through managed care entities to hospitals.
\* Audit Support Assist Auditors (State & Independent) with the annual review of DSH, GME, UPL, and Hospital Directed Payments by providing support documentation and explanation of the models.
\* Assemble audit identified materials after the completion of the final payment for each model year.**Knowledge Skills and Abilities/Management Preferences****Salary Grade Range $53,164 - $93,038**
**Recruitment Range** **$53,164 - $70,000****\*\*Position is eligible for a hybrid-teleworking schedule to include weekly onsite work hours\*\*****Knowledge Skills and Abilities/Management Preferences**Candidates now meet the minimum qualifications of a position if they meet the minimum education and experience listed on the vacancy announcement.The Knowledge, Skills, and Abilities (KSAs)/ Management Preferences are not required. Applicants who possess the following skills are preferred:* Experience working with large workbooks* Experience creating formulas in MS Excel**This position will close at 11:59 p.m. the night before the end date.****This Position Is Funded in Part Through Federal Funds****About the NC Division of Health Benefits:**
**The Division of Health Benefits (DHB)** within NCDHHS is committed to advancing innovative solutions that improve health, promote well-being and foster independence for all North Carolinians. DHB manages and oversees North Carolina Medicaid and other programs that provide access to services and supports for parents, children, seniors, people with intellectual / developmental disabilities, and behavioral health, substance use and traumatic brain injury disorders. With a budget over $27 billion in state and federal funds per fiscal year, DHB ensures that more than 108,000 enrolled providers are reimbursed for delivering covered services to 3.1 million beneficiaries.**Compensation & Benefits:**
The State of North Carolina offers excellent comprehensive benefits.
Employees can participate in health insurance options, standard and supplemental retirement plans, and the NCFlex program (numerous high-quality, low-cost benefits on a pre-tax basis).
Employees also receive paid vacation, sick, and community service leave.
In addition, paid parental leave is available to eligible employees.
Visit website for## **Supplemental and Contact Information**## The North Carolina Department of Health and Human Services (DHHS) is an Equal Opportunity Employer that embraces an Employment First philosophy, which consists of complying with all federal laws, state laws, and Executive Orders.
We are committed to reviewing requests for reasonable accommodation at any time during the hiring process or while on the job.
For more information about DHHS: .DHHS uses the Merit-Based Recruitment and Selection Plan to fill positions subject to the State Human Resources Act with the most qualified individuals.
Hiring salary will be based on relevant qualifications, internal equity, and budgetary considerations pertinent to the advertised position.In accordance with the Governor’s , our agency supports second-chance employment for individuals who were previously incarcerated or justice-involved.
We invite all potential applicants to apply for positions for which they may be qualified.
Application Process
**Be sure to complete the application in its entirety.** *Resumes will not be accepted in lieu of completing this application.** Information should be provided in the appropriate areas, to include the following: Education, including high school and all degrees obtained, Work Experience, and Certificates & Licenses. It is critical to our screening and salary determination process that applications contain comprehensive candidate information.* Answers to Supplemental Questions are not a substitute for providing all relevant information within the body of your application. To receive credit for the supplemental questions, you must provide supporting information within the "Work Experience" section of the application to support your answers.* If multiple applications are submitted to an individual posting, only the most recent application received prior to the closing date will be accepted. Applications must be submitted by 11:59 PM on the closing date.* Applicants may be subject to a criminal background check. All candidates selected for positions considered "Positions of Trust" will be subject to a criminal background check.* Due to the volume of applications received, we are unable to provide information regarding the status of your application over the phone. To check the status of your application, please log in to your account.
Upon the closing date, applications are "Under Review" and will be screened by Human Resources for qualified applicants. The hiring process may take several weeks.* Degrees must be received from appropriately accredited institutions.
Transcripts and degree evaluations may be uploaded with your application. The State of North Carolina/Office of State Human Resources #J-18808-Ljbffr