Department of Administrative Services

DMHAS Health Care Policy Program Director (8493MP)

$44.97-$61.32 Hourly / $3,597.55-$4,905.25 BiWeekly /
$93,896.00-$128,027.00 Yearly


PURPOSE OF JOB CLASS (NATURE OF WORK)

In the Department of Mental Health and Addiction Services this class is accountable for directing the determination of reimbursement rates for contracts negotiated by the department for the provision of behavioral health services or coordination of all revenue reimbursement efforts.

SUPERVISION RECEIVED

Receives direction from the Chief of Fiscal/Administrative Services or other administrative official of higher grade.

SUPERVISION EXERCISED

Directs professional and clerical staff of unit as assigned.

EXAMPLES OF DUTIES

Directs staff and operations of a healthcare finance or billing unit; coordinates, plans and manages unit activities; formulates program goals and objectives; develops or assists in development of related policy; establishes and maintains unit procedures; manages development of new program initiatives involving financial and cost analysis, rate setting, billing and cost containment or recovery; initiates, interprets and administers pertinent laws; evaluates staff; maintains contacts with individuals both within and outside unit who might impact on program activities including insurance and managed care providers; coordinates within and outside agency regarding billing and revenue data, Medicare Cost report information and related data; assists in planning and implementation of financial and billing aspects of managed care programs; prepares and analyzes complex financial statements, reports and budget requests; projects expenditures and assists in financial planning; prepares revenue projections and analyzes agency changes for impact on revenue; analyzes and provides information on impact of agency policies, staffing and treatment protocols on rates and revenue and/or reimbursement; manages staff and activities for purpose of obtaining maximum reimbursement; provides training and education to managed care providers to ensure billing requirements are met; ensures managed care provider compliance allowing for federal reimbursement for services rendered; analyzes and interprets federal and state laws and regulations as they pertain to rate setting and revenue and/or reimbursement; conducts data analysis of claims payments, analysis of services billed/not billed and payments made/not made; coordinates re-billing with the Department of Administrative Services; oversees setup of service codes, insurances, diagnosis code updates and other billing related tables; may negotiate agreements for medical care services with professional groups and service providers; may testify at legislative hearings regarding agency efforts to set rates and expand sources of revenue; performs related duties as required.

KNOWLEDGE, SKILL AND ABILITY

Considerable knowledge of and ability to apply management principles and techniques; considerable knowledge of and ability to apply relevant state and federal laws, statutes and regulations; considerable knowledge of principles of health care administration, financial management and billing administration; considerable knowledge of health care budgeting principles; considerable knowledge of principles of cost analysis; considerable interpersonal skills; considerable oral and written communication skills; considerable ability to prepare and interpret financial and statistical reports.

MINIMUM QUALIFICATIONS - GENERAL EXPERIENCE

Nine (9) years of experience in cost accounting, cost analysis, financial management, or policy analysis for revenue maximization.

MINIMUM QUALIFICATIONS - SPECIAL EXPERIENCE

One (1) year of the General Experience must have been in a supervisory capacity over professional staff involved in health care cost analysis.

NOTE: For state employees the Special Experience is interpreted as one (1) year of experience at the level of Fiscal Administrative Supervisor performing health care cost analysis or Principal Health Care Analyst.

MINIMUM QUALIFICATIONS - SUBSTITUTIONS ALLOWED

  1. College training may be substituted for the General Experience on the basis of fifteen (15) semester hours equalling one half (1/2) year of experience to a maximum of four (4) years for a Bachelor's degree.
  2. A Master’s degree in a closely related field may be substituted for one (1) additional year of the General Experience.
  3. A law degree may be substituted for one (1) additional year of the General Experience.

JOB CLASS DESIGNATION

Classified/Competitive

OCCUPATIONAL GROUP

(04)-Business Management

BARGAINING UNIT

(02)-MANAGERIAL

EEO

(1)-Officials And Administrators

SALARY INFORMATION

MP 67

CANCELLATION CLAUSE

This replaces the existing specification for the class of Department of Mental Health and Addiction Services Director of Health Care Finance in Salary Group MP 66 approved February 11, 2011. (Revised to modify content, re-evaluation and re-title)

EFFECTIVE DATE

2/1/18

CLASS: 8493MP; EST: 1/2/1998; REV: 2/1/2018;