The North Carolina Department of Health and Human Services (DHHS) is one of the largest, most complex agencies in the state, responsible for ensuring the health and well-being of all North Carolinians. The Financial Analyst II will serve as the Technical Specialist for State Directed Payments, ensuring compliance with federal regulations and managing complex annual and quarterly models for payment calculations.
Responsibilities
- Serve as the Technical Specialist for State Directed Payments to support the design, implementation, evaluation and compliance monitoring of Medicaid managed care payment arrangement
- Ensure that the SDPs align with federal regulations under 42 CFR β 438.6 (c) and meet Center of Medicare and Medicaid Services requirement for transparency, quality, and fiscal integrity
- Communicate with and ensuring all data has been furnished in a timely fashion to update the model; this includes all supporting provider schedules, cost reports and 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 model to calculate all necessary hospital assessments (provider tax) and intergovernmental transfers (IGT) receipts which 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 reviews for accuracy, changes, and compliance with federal and state legislation and regulatory requirements and CMS approved Managed Care Preprints
- Coordinate with all stakeholders and executes the timing, invoicing and collection of all quarterly/ annual hospitals receivables based on these models, and tracking receipts through to completion and following up on any missing / delayed payments pursuant to legislative authority
- Coordinates with all stakeholders and executes 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
Skills
- Bachelor's degree in accounting, banking, finance, business administration, economics, or related discipline from an accredited institution and 1 year of directly related experience or an equivalent combination of education and experience
- Experience working with large workbooks
- Experience creating formulas in MS Excel
Company Overview
The N.C. It was founded in 2015, and is headquartered in Raleigh, North Carolina, USA, with a workforce of 1001-5000 employees. Its website is https://it.nc.gov.
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