The State of Connecticut, Department of Mental Health and Addiction Services (DMHAS), is a health care agency whose mission is to promote the overall health and wellness of persons with behavioral health needs through an integrated network of holistic, comprehensive, effective, and efficient services and supports that foster dignity, respect, and self-sufficiency in those we serve.
Are you a hardworking, motivated Finance professional looking to make a difference while working with a collaborative team in the public sector? If so, we want you to join us at the DMHAS Office of the Commissioner!
We are seeking a qualified individual for the role of Health Care Analyst (PCN 103689), within our Fiscal Services Division. Our team members are passionate about the work we do. We are conveniently located at 410 Capitol Avenue in Hartford. This is a full-time, 40 hour per week position with work schedule of Monday – Friday, 8:00am – 4:30pm.
DISCOVER THE OPPORTUNITY TO:
- Ensure the Medicare and Medicaid billing associated with billable services (Inpatient, inpatient professional services, outpatient, targeted case management and behavioral health home services) provided by 7 DMHAS and 30+ private, non-profit DMHAS providers is maximized and completed in accordance with state and federal guidelines.
- Research and analyze data that is received from providers and that is released for billing.
- Analyze Explanation of Benefits reports for further billable opportunities.
- Work closely with program staff who provide and monitor service delivery.
- Provide training to staff of state agencies and private non-profit agencies, as needed.
- Prepare regular and special project data reports that analyzes service delivery, billing and revenue data.
- Ongoing research of billing opportunities to increase revenue.
- Produce reports routinely requested by the Department of Social Services, Office of Policy and Management, the State Legislature, Center for Medicare and Medicaid Services and other agencies.
- Work together with state and private agencies, assisting in their understanding of billing reports, requirements and billable service delivery.
- Track Medicare and Medicaid enrollment of providers.
- Work conjointly with IT and DAS on system errors and on system changes, as needed.
In order to be considered for this job opening, you must meet the Minimum Qualifications as listed on the job opening. You must specify your qualifications on your application.
*You will be unable to make revisions once you submit your application for this posting to the JobAps system.
Interviews will be limited to candidates whose experience most closely meet the preferred requirements of the position. Applicants invited to interview may be required to submit additional documentation, which supports their qualification(s) for this position. These documents may include: performance reviews, supervisory references, college transcripts, licensure, etc., at the discretion of the hiring agency.
This position will be filled in accordance with contractual language, reemployment, SEBAC, transfer, promotion and merit employment rules.
As a reminder:
- The minimum experience and training requirements must be met by the close date on the job opening, unless otherwise specified.
- Due to the volume of applications anticipated, we are unable to provide confirmation of receipt or status during the recruitment process. Updates will be provided through your JobAps portal account.
- This posting may require completion of additional referral questions (RQs) which will be sent to you via email after the closing date. The email notification will include an expiration date by which you must submit (Finish) your responses.
- Applications to this recruitment may be used for future vacancies.
- Please regularly check your email for notifications. Please check your SPAM and/or Junk folders, as emails could end up there in error.
For more information, we encourage you to contact the recruiter for this position, Joseph K. Fried at Joseph.Fried@ct.gov, (860) 924-7053.
PURPOSE OF JOB CLASS (NATURE OF WORK)
In the Departments of Mental Health and Addiction Services, Public Health, Social Services or the Office of the State Comptroller, this class is accountable for independently performing a full range of tasks in the analysis of financial, utilization and management records of health care facilities and/or providers or health insurance providers.
EXAMPLES OF DUTIES
Reviews materials to determine compliance with requirements contained in Connecticut General Statutes and agency regulations; reviews and evaluates financial, utilization and management records of health care facilities and/or providers toward various ends; prepares financial, narrative and statistical reports; reviews findings and conclusions with audit staff and members of senior staff; performs special research projects as assigned; performs related duties as required.
DEPARTMENT OF PUBLIC HEALTH: Reviews various health care facility and/or physician Certificate of Need applications; analyzes impact of proposals on other health care providers in Connecticut and makes recommendations; writes related documents and assists employees of higher grade in writing decisions; assists in preparing documentation for administrative hearings; researches and analyzes data in preparation of various health care industry reports; performs related duties as required.
DEPARTMENT OF SOCIAL SERVICES: Analyzes and evaluates budget, expenditure, utilization, reimbursement rate setting and/or revenue issues within social services programs, including Medicaid; participates in public hearings and assists in conferring with representatives of facilities and outside experts; interacts, under guidance, with Office of the Attorney General in litigation including preparation of complete court records; may review Certificate of Need applications for nursing facility, residential care homes and ICF/MR development; performs related duties as required.
DEPARTMENT OF MENTAL HEALTH AND ADDICTION SERVICES: Analyzes and evaluates budget, expenditure, utilization, rate setting and/or revenue issues within behavioral health; analyzes General Assistance authorizations and expenditures, rate setting scenarios and new methodologies; performs related duties as required.
OFFICE OF THE STATE COMPTROLLER: Analyzes financial and utilization data from vendor and state records concerning state employees and retirees health care plans; answers inquiries from employees and retirees on issues of coverage and design pertaining to state health care plans; performs related duties as required.
KNOWLEDGE, SKILL AND ABILITY
Knowledge of principles and practices of financial management including organization, administration, management, finance, budgeting, auditing and accounting; some knowledge of health care industry; interpersonal skills; oral and written communication skills; ability in interpretation and analysis of complex financial, statistical and technical data; ability to utilize computer software.
MINIMUM QUALIFICATIONS - GENERAL EXPERIENCE
Six (6) years of professional experience in financial management with some experience in health care management.
Note: Financial management is defined as professional accounting or auditing work with responsibility for the review and recommendation of financial policies and procedures of a business organization.
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, finance or other closely related field or public health with some college courses in accounting or finance may be substituted for one (1) additional year of the General Experience.
3. Professional experience in health care facility administration, health program administration, health insurance administration, health planning or other health care related fields may be substituted for the General Experience on a year for year basis to a maximum of one (1) year.
Our ideal candidate will:
- Have experience using Microsoft Excel, including: VLOOKUP functions, pivot tables, setting up spreadsheets, utilizing functions, and managing and formatting data and formulas.
- Have experience with Outpatient billing
- Have knowledge of the Current Procedural Terminology (CPT) codes associated with Outpatient billing
- Have knowledge of Explanation of Benefits (EOB) associated with Outpatient billing
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.