Cost Reporting & Rate Setting Manager

University of Massachusetts Medical School; Westborough (MA); On-site; USD 110,000 - 170,000; Full time

Job summary

The University of Massachusetts Medical School is seeking a Cost Reporting and Rate Setting Manager to oversee the unit's cost reporting activities and to calculate payment rates for health care services.

This role leads data analysts and consultants, produces work papers for CMS/state reports, collaborates with Medicaid and EOHHHS, and drives continuous improvement in financial operations.

Qualifications

• Bachelor's degree in Finance, Business Administration or a related field.
• 7 years' experience in fiscal management, finance, public administration or health care with supervisory experience.
• Knowledge of accounting principles, budgeting and financial report preparation.
• Experience in financial management and complex environments.
• Ability to prioritize and meet competing deadlines and travel to off-site locations.
• Intermediate Microsoft Excel and Microsoft Office skills.

Responsibilities

• Manage cost reporting activities for state owned hospitals, clinics, nursing facilities and soldiers’ homes.
• Calculate payment rates for health care services at state owned facilities.
• Prepare and submit Cost Allocation Plans for health and human services agencies.
• Develop, implement and evaluate program goals and objectives.
• Supervise and evaluate staff, manage workflow and priorities.
• Prepare performance management reports and ensure compliance with regulations.
• Collaborate with Office of Medicaid, EOHHS and state agencies to optimize client services.
• Maintain and update business documents and participate in continuous quality improvement.

Skills

Management abilities

Microsoft Excel

Microsoft Office

Travel flexibility

Education

Bachelor's degree in Finance, Business Administration or a related field

Master's degree in Finance, Business, Public or Health Care Administration or a related field

Tools

MMARS

Cognos

Meditech

Microsoft Excel

Job description

Overview

GENERAL SUMMARY OF POSITION:

Under the general direction of the Assistant Director or designee, the Cost Reporting and Rate Setting Manager is responsible for all cost reporting activities for the unit as well as calculating and setting payment rates for health care services. This entails the management of data analysts and consultants along with the production of work papers supporting the yearly CMS and state cost reports for 18 state operated facilities. The different report types are listed below.

CMS – 2552, 2540, 2088

CHIA (State) – 403, ICF, HCF-1

OSD (State) – UFR

The manager is also responsible for overseeing rate setting activities for those facilities as well as recommending Medicaid claiming rates for community based programs including those for rehabilitative and home and community based services authorized by an approved Medicaid Waiver.

The Provider Rate and Administrative Cost Reimbursement Unit (PRACRU) within the Center for Health Care Financing produces the quarterly Medicaid administrative claims on behalf of the University and completes Medicare/Medicaid cost reports, calculates rates for community based programs, computes unreimbursed costs for state hospitals, and recommends upper payment limits for certain state owned services. These responsibilities are performed on behalf of the Executive Office of Health and Human Services (EOHHS) in accordance with an interagency agreement.

Responsibilities

MAJOR RESPONSIBILITIES:

• Responsible for the management of cost reporting activities including compiling, preparing, reviewing and submitting all required reports for all state owned non-acute hospitals, clinics, nursing facilities, and soldiers’ homes.
• Calculate payment rates for health care services at state owned non-acute hospitals and community-based programs.
• Compile, prepare, review and submit Cost Allocation Plans for health and human services agencies, as needed.
• Develop, implement and evaluate program goals and objectives.
• Responsible for the calculation of unreimbursed costs at state owned non-acute hospitals.
• Responsible for the calculating and recommending of the upper payment limits for state owned and operated services.
• Interview, make hiring recommendations, train, supervise and evaluate staff.
• Manage workflow and priorities.
• Prepare performance management reports.
• Monitor contract services and provide feedback about the quality of vendor’s work.
• Identify and apply best business practices.
• Collaborate with the staff of the Office of Medicaid, EOHHS, state agencies and other organizations to provide optimum client services in accordance with the service agreement.
• Write, review and maintain business documents including reports, contracts, manuals, procedures and presentations
• Participate in and implement continuous quality improvement initiatives such as an internal control plan and procedure manuals.
• Promote compliance with state and federal rules and regulations.
• Work independently and as a team member and leader.
• Preserve confidential information and files.
• Perform additional duties as required.

Qualifications

REQUIRED QUALIFICATIONS:

• Bachelor's degree in Finance, Business Administration or a related field
• 7 years' experience in fiscal management, finance, public administration or health care; with at least two years of demonstrated supervisory experience
• Knowledge of accounting principles, budgeting and financial report preparation.
• Experience in financial management.
• Proven management abilities in a complex environment.
• Proven ability to prioritize and coordinate multiple tasks and meet competing deadlines.
• Intermediate Microsoft Excel and Microsoft Office skills.
• Ability to travel to off-site locations.

PREFERRED QUALIFICATIONS:

• Master's degree in Finance, Business, Public or Health Care Administration or a related field
• Knowledge of state information systems such as the Massachusetts Management Accounting and Reporting System (MMARS) and Cognos.
• Advanced Microsoft Excel and Access software skills.
• Knowledge of state and federal rules and regulations as related to health care finance.
• Knowledge and experience with Meditech and other patient accounting systems.
• Knowledge of Medicare/Medicaid cost reporting and accounting.