The State of Connecticut
, Department of Social Services (DSS
), is recruiting a Social Services Director of Rate Setting and Certificate of Need (CON), which is a leadership position within the management team of DSS' Division of Health Services (DHS), located at 55 Farmington Avenue in Hartford, CT. This position is full-time, 40 hours per week, Monday - Friday.
This position is critical to the mission, reform agenda, and operations of DSS and DHS in its administration of Medicaid, the Children’s Health Insurance Program, the major Money Follows the Person federal grant, and particularly in-care delivery and value-based payment reforms.
The Reimbursement & CON Unit is responsible for the design and implementation of federally approved reimbursement methodologies, federal revenue maximization activities, analytics, budget projections, revenue projections, strategic planning and technical assistance in order to maintain an economic and efficient Medicaid provider network. The unit also performs certificate of need (CON) reviews for healthcare facility developments, renovation projects, capacity increases/decreases and closures. Over the past eight years the role of the unit has changed significantly as the Department modernized old reimbursement methodologies in order to meet more stringent federal requirements and to modernize reimbursement methodologies that factor acuity, quality and outcomes into the reimbursement methodology.
Candidates selected for interview must bring the following at the time of interview:
Non State Employees:
- Three professional references.
- Two most recent service ratings/PARS.
- Attendance records for the last two years.
Should you have questions pertaining to this recruitment, please contact Letonia Wright at firstname.lastname@example.org, (860) 424-4929.
PURPOSE OF JOB CLASS (NATURE OF WORK)
In the Department of Social Services this class is accountable for directing staff involved in determining state reimbursement rates for services covered by department assistance programs; auditing of provider cost reports; performing certificate of need reviews for nursing facilities and Intermediate Care Facilities for the Persons with Intellectual Disabilities (ICF/MR) development projects and determining maximum public charges for home health services.
EXAMPLES OF DUTIES
- Supervises planning, day-to-day operations and management of the team of staff in the Reimbursement & CON Unit.
- Liaises regularly with DSS and DHS leadership, the federal Centers for Medicare and Medicaid Services, the Connecticut General Assembly and the Office of Policy & Management.
- Responsible for cost report auditing for nursing facility, Intermediate care facility/mental retardation (ICF/MR), residential facilities, Federally Qualified Community Health Centers (FQHCs), Methadone Clinic and Medicaid waiver services provided by other state agencies.
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 and financial management; considerable knowledge of health care budgeting principles; considerable knowledge of principles of cost analysis; considerable ability in preparation and interpretation of financial and statistical reports; considerable interpersonal skills; considerable oral and written communication skills.
MINIMUM QUALIFICATIONS - GENERAL EXPERIENCE
Ten (10) years' professional experience in a social services agency, health related facility or health insurance industry.
MINIMUM QUALIFICATIONS - SPECIAL EXPERIENCE
Two (2) years of the General Experience must have been in a managerial capacity involving cost filing preparation, reimbursement and rate setting policies.
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 accounting, business administration, hospital administration or a closely related field may be substituted for one (1) additional year of the General Experience.
- Exposure to, experience with and/or training in Medicaid and the Children’s Health Insurance Plan (CHIP).
- Expertise in health insurance rate setting and value-based payment approaches.
- Experience in leading dynamic teams.
- Experience in liaising with diverse stakeholders, including federal government agencies, policymakers, health providers and advocates.
- Expertise in translating complex concepts into accessible messages.
- Proficiency with complex computations and presentation of data.
- Capacity to creatively and rapidly react to requests and deliverables with tight turn-around times.
AN AFFIRMATIVE ACTION/EQUAL OPPORTUNITY EMPLOYER
The State of Connecticut is an equal opportunity/affirmative action employer and strongly encourages the applications of women, minorities, and persons with disabilities.