Financial Specialist Principal - MED

Description

DEDICATED TO STRENGTHENING THE HEALTH, SAFETY, AND INDEPENDENCE OF IDAHOANS

Applications will be accepted through 4:59 PM MST on the posting end date. 

The Idaho Department of Health and Welfare, Division of Medicaid, is currently seeking aFinancial Specialist Principalwith experience in Medicaid or other health care industry work including government or private health care. This position is located inBoise.

As Financial Specialist Principal, you will be responsible for the management of the Medicaid Reimbursement Unit, updating rates as supported by state appropriations, calculating payments, implementing reimbursement policy, collaborating with contractors, and ensuring compliance with federal and state laws and regulations. This position will complete oversight of activities related to Medicaid reimbursement for providers including but not limited to hospitals, home health agencies, fee schedules, clinics, physicians, managed care, value care, graduate medical education, and supplemental payment programs. This position works directly with internal and external stakeholders via email, in-person and virtual meetings, and phone calls. Stakeholders include but are not limited to Division and department program support staff, provider groups, provider associations, third-party contractors, and the Center for Medicare and Medicaid Services (CMS) staff.

We are seeking highly-organized candidates with experience researching and analyzing documents to ensure compliance with federal and state laws, regulations, and accounting principles; supervising staff; communication and interpersonal skills; problem solving skills; critical thinking skills and team learning competencies.

This position may be eligible for telework after successful completion of probation and necessary training.

BENEFITS:

 We have one of the Nation's best state retirement systems (PERSI) that offers a lifetime benefit. 

 OTHER EXCELLENT BENEFITS

• 11 paid holidays
• Generous vacation and sick leave accrual beginning as soon as you start 
• Paid parental leave
• Medical, dental, vision insurance - incredible rates!(full-time/30+ hours per week)
• PERSI Choice 401(k)
• Deferred compensation plan
• Life insurance
• Short and long-term disability insurance
• Student Loan Forgiveness
• Wellness programs
• Employee Assistance Program (EAP)
• Flexible Spending Accounts (FSA) 
• Wide variety of training opportunities
• Some positions offer flexible hours and/or telecommuting

EXAMPLE OF DUTIES:

• Manage staff to perform daily reimbursement tasks for hospitals, home health agencies, Federally Qualified Health Centers (FQHC), Rural Health Clinics (RHC), Durable Medical Equipment (DME), physicians, Graduate Medical Education (GME), fee schedules, managed care, and supplemental payment programs. 
• Review, understand, and apply federal and state rules, regulations, guidelines, and trends to make recommendations for policy changes related to healthcare billing and coding, Medicaid reimbursement activities, value care and managed care. 
• Collaborate with policy and management to draft changes to rule, state plan, fee schedules, waivers, or provider reimbursement. 
• Reconcile, audit, approve and report on expenditures, budgets, provider reimbursement, and other financial data with internal and federal systems for completeness and compliance with reimbursement policy and agreements such as the Upper Payment Limit (UPL) for hospitals, GEMT, and clinics; Diagnosis-Related Group (DRG) re-basing; cost settlements; prospective payment systems; cost effective workbooks; and Disproportionate Share Hospitals (DSH) audits. 
• Support the annual managed care rate development and review process, in conjunction with program staff and the department’s actuaries. 
• Foster professional interpersonal relationships with other intergovernmental financial professionals, program budgeting, and project managers within the department. This includes providing technical guidance to Medicaid systems, internal staff, providers and stakeholders for reimbursement questions. 
• Support the development and maintenance of financial policies and procedures, contract monitoring, and procurement activities related to provider reimbursement. 
• Assist with routine cost and analysis functions for value care, managed care, fee for service, and supplemental payments across various provider types. 
• Process requests for hearings and administrative reviews for provider appeals. • Complete other duties, tasks, or assignments as assigned by management.

MINIMUM QUALIFICATIONS:

You must possess all the minimum qualifications below to pass the exam for this position. Please make sure your resume or work history supports your meeting the minimum qualifications for this position. Failure to do this may disqualify you from being considered for this position.It is highly recommended to attach a one-page cover letter to your application to demonstrate how you meet the requirements below.

• Good knowledge of accounting principles and practices.Typically requires four or more years of professional work experience as an accountant or equivalent applying Generally Accepted Accounting Principles (GAAP)ORan Associate's degree in Accounting AND at least two years of professional work experience such as an accountant or equivalentOR a Bachelor's degree or higher that includes 20 semester hours, or equivalent college coursework in AccountingOR four or more years of professional work experience as an accountant, or equivalent, applying Generally Accepted Accounting Principles (GAAP) AND at least 12 semester credits in Accounting, to include Intermediate Accounting I and II.
• Good knowledge of supervisory practices.Typically requires at least one year of experience performing as a supervisor which required work assignment, direction, and monitoring staff with responsibility (or significant input) into the hiring of employees, preparing performance evaluations, and handling problem-solving proceduresOR8 hours of courses or seminars specifically covering supervisory practices PLUS at least 6 months experience performing as a full supervisorORcompletion of 6 college credit hours of courses or seminars covering the essential elements of management (planning, organizing, leading and controlling).
• Experience using personal computers to develop, analyze, and report on financial data.Typically requires two or more years of work experience where using a personal computer to develop, analyze, and report on financial data/documents was a regularly assigned job duty.
• Experience monitoring/reviewing internal financial controls. Typically requires at least one year of professional level experience monitoring/reviewing internal financial controls.
• Experience resolving technical accounting, auditing, or budgeting problems. Typically requires at least one year of professional level experience resolving technical accounting, auditing, and/or budgeting problems.
• Experience preparing financial documents for management review.Typically requires one or more years of full-time work experience preparing financial documents for management review.
  
• Experience analyzing financial activities and recommending or implementing management actions.Typically requires one or more years of full-time work experience independently analyzing financial activities and recommending management action as a regularly assigned job duty.

Below is preferred experience. It is not required for the position but applicants with this experience may receive consideration over other applicants.

• Knowledge of Private or Public Healthcare.Typically gained by at least one (1) year of experience in a public or private health care setting, managed care setting, value care setting or insurance billing clearing house where use of medical codes was a function of the job. 
• Experience in business operations working with financial data, setting reimbursement rates, or budget oversight.Typically gained by at least one (1) year of experience working with large computer systems to process financial data or rate setting.

Learn About a Career with DHW

***PLEASE NOTE: application assistance is not available after the business hours listed below, on the weekends, or on holidays and you must apply before 4:59 pm on the closing date. When applying, use CHROME as your browser to avoid complications.

If you have questions, please contact us at:

Email is the quickest way to get an answer to your questions.

(answered Monday through Friday during business hours MST)

EMAIL:[email protected] 

PHONE: (208) 334-0681

EEO/ADA/Veteran:

The State of Idaho is committed to providing equal employment opportunities and prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on their race, color, religion, political affiliation or belief, sex, national origin, genetics, or any other status protected under applicable federal, state, or local laws.

The State of Idaho is committed to access and reasonable accommodations for individuals with disabilities, auxiliary aids and services are available upon request. If you require an accommodation at any step in our recruitment process, you are encouraged to contact (208) 334-2263 (TTY/TTD: 711), or email [email protected].

Preference may be given to veterans who qualify under state and federal laws and regulations.