NC Department of Health and Human Services
Financial Analyst II
NC Department of Health and Human Services, Raleigh, North Carolina, United States
Financial Analyst II (NS)
Department: North Carolina Department of Health and Human Services (NC DHHS)
Division: Health Benefits (Division of Health Benefits)
Position Number: 60042633
Grade: NC15
Salary Grade Range: $53,164 - $93,038
Recruitment Range: $53,164 - $70,000
Hybrid schedule available. Work 1‑2 days onsite per week while teleworking.
About Us: The 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.
Job Description: 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 arrangements.
Ensure that the SDPs align with federal regulations under 42 CFR Title 42 Part G (c) and meet Center of Medicare and Medicaid Services requirements for transparency, quality, and fiscal integrity.
Communicate with stakeholders and ensure all data has been furnished in a timely fashion to update the model; this includes all supporting provider schedules, cost reports, 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 models to calculate all necessary hospital assessments (provider tax) and intergovernmental transfers (IGT) receipts that 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 review them for accuracy, changes, and compliance with federal and state legislation and regulatory requirements and CMS approved Managed Care Preprints.
Coordinate with all stakeholders and execute the timing, invoicing, and collection of all quarterly/annual hospital receivables based on these models, and track receipts through to completion and follow up on any missing/delayed payments pursuant to legislative authority.
Coordinate with all stakeholders and execute 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 & Abilities (Preferred):
Experience working with large workbooks.
Experience creating formulas in MS Excel.
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. Paid parental leave is available to eligible employees.
Equal Employment Opportunity Statement: The State of North Carolina is an Equal Employment Opportunity Employer and is committed to providing an employment environment free from unlawful discrimination, harassment, or retaliation. The agency affirms reasonable accommodation for employees and applicants with disabilities, pregnancy, religious beliefs, and other protected statuses.
Minimum Education & Experience:
Bachelor’s degree in accounting, banking, finance, business administration, economics, or a related discipline from an accredited institution and 1 year of directly related experience.
Alternatively, an equivalent combination of education and experience.
Contact: Talent Acquisition: talentacquisition@dhhs.nc.gov
Application Note: Resumes will not be accepted in lieu of completing the online application.
Position will close at 11:59 p.m. the night before the posting’s end date.
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Division: Health Benefits (Division of Health Benefits)
Position Number: 60042633
Grade: NC15
Salary Grade Range: $53,164 - $93,038
Recruitment Range: $53,164 - $70,000
Hybrid schedule available. Work 1‑2 days onsite per week while teleworking.
About Us: The 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.
Job Description: 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 arrangements.
Ensure that the SDPs align with federal regulations under 42 CFR Title 42 Part G (c) and meet Center of Medicare and Medicaid Services requirements for transparency, quality, and fiscal integrity.
Communicate with stakeholders and ensure all data has been furnished in a timely fashion to update the model; this includes all supporting provider schedules, cost reports, 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 models to calculate all necessary hospital assessments (provider tax) and intergovernmental transfers (IGT) receipts that 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 review them for accuracy, changes, and compliance with federal and state legislation and regulatory requirements and CMS approved Managed Care Preprints.
Coordinate with all stakeholders and execute the timing, invoicing, and collection of all quarterly/annual hospital receivables based on these models, and track receipts through to completion and follow up on any missing/delayed payments pursuant to legislative authority.
Coordinate with all stakeholders and execute 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 & Abilities (Preferred):
Experience working with large workbooks.
Experience creating formulas in MS Excel.
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. Paid parental leave is available to eligible employees.
Equal Employment Opportunity Statement: The State of North Carolina is an Equal Employment Opportunity Employer and is committed to providing an employment environment free from unlawful discrimination, harassment, or retaliation. The agency affirms reasonable accommodation for employees and applicants with disabilities, pregnancy, religious beliefs, and other protected statuses.
Minimum Education & Experience:
Bachelor’s degree in accounting, banking, finance, business administration, economics, or a related discipline from an accredited institution and 1 year of directly related experience.
Alternatively, an equivalent combination of education and experience.
Contact: Talent Acquisition: talentacquisition@dhhs.nc.gov
Application Note: Resumes will not be accepted in lieu of completing the online application.
Position will close at 11:59 p.m. the night before the posting’s end date.
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