State of Maryland

HEALTH SERVICES RATE ANALYST, ADVANCED (#006236)

- Hourly / - BiWeekly /
- Monthly / $53,214.00-$85,398.00 Yearly


GRADE

18

NATURE OF WORK

Health Services Rate Analyst, Advanced is the advanced level of work setting rates hospitals charge for health services and auditing hospital records for compliance with established rates. Employees in this classification perform advanced duties as rate setting technical advisor to the Health Services Cost Review Commission (HSCRC) during the periodic complete review of contested hospital rate cases. Employees in this classification do not supervise.

Employees in this classification receive general supervision from a Health Services Rate Analyst Supervisor or other designated administrator.

The Health Services Rate Analyst, Advanced is differentiated from the Health Services Rate Analyst II in that the Health Services Rate Analyst, Advanced performs advanced duties as rate setting technical advisor to the HSCRC during the periodic complete review of contested hospital rate cases, while the Health Services Rate Analyst II performs the full range of duties under general supervision. The Health Services Rate Analyst, Advanced is differentiated from the Health Services Rate Analyst Supervisor on the basis of supervisory responsibility. The Health Services Rate Analyst Supervisor has full supervisory responsibility for lower-level Health Services Rate Analysts.

EXAMPLES OF WORK

Reviews, independent from the HSCRC staff, hospital full rate applications and HSCRC staff recommendations coming before the Commission;

Reviews pre-filed testimony from all parties before formal hearings;

Examines, identifies and formally delineates contested issues of cases with the Hearing Officer and the Commission's attorney;

Interprets HSCRC staff recommendations in relation to the long-term impact on HSCRC laws, regulations or policies;

Advises Commissioners during formal hearings regarding any technical questions on rate setting methods and techniques;

In conjunction with the Hearing Officer and the Commission's attorney, drafts proposed decisions on contested issues;

Responds to inquiries from the full Commission regarding proposed decisions;

In conjunction with the Commission's attorney, prepares final decisions on contested rate cases after all Commission concerns have been addressed;

Reviews financial data from hospitals for completeness, accuracy, validity and adequacy for rate setting purposes;

Determines the scope and nature of analysis of financial data required to set reasonable rates to be charged for health services;

Performs calculations to develop inflation factors, inpatient rate changes, price leveling factors and case mix adjustments;

Applies appropriate rate setting methodologies required for inflation adjustments, guaranteed inpatient revenue adjustments and whole or partial rate reviews;

Modifies rate setting methodologies for special factors or circumstances such as rate reductions and changes in intensity factors;

Prepares manual and computerized workpapers to document the rate setting process;

Discusses proposed rates with hospital officials, physicians and health insurance officials to gather information and explain the basis of rate proposals;

Presents empirical evidence summarized into staff recommendations presented to the HSCRC on the effectiveness and efficiency of proposed rates;

Prepares testimony and provides background information for presentation at formal and informal hearings in order to explain and defend rate reviews and analyses;

Audits annual financial statements of hospitals;

Assists with proposed spend-downs for hospitals to bring health services down to reasonable levels;

Interprets and applies HSCRC regulations and policies in the review of hospital rate proposals;

Performs other related duties.

GENERAL REQUIREMENTS

Specific educational and experience requirements are set by the agency based on the essential job functions assigned to the position.

ACKNOWLEDGEMENTS

A Class Description provides information about the Nature of Work, Examples of Work and General Requirements for a classification in the Management Service or a classification in the Skilled or Professional Service in which all positions have been designated Special Appointments. Required Knowledge, Skills, and Abilities; Minimum Education and Experience Requirements; Special Requirements; and recruitment and testing procedures are set by the using agency. Class descriptions broadly define groups of positions used by various State departments and agencies. Position descriptions maintained by the using department or agency specifically address the essential job functions of each position.

Date Established

Jul 1 1995 12:00AM

Approved By

Director, Division of Classification and Salary

CLASS: 006236; EST: 7/1/1995; REV: ;

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