Health Care Analyst (Office/On-Site)

State-of-Connecticut---Department-of-Veterans-Affair; Rocky Hill (CT); On-site; USD 80,000 - 120,000; Full time

Benefits offered by this job

Professional growth and development

Healthy work/life balance

Job summary

The State of Connecticut Department of Veterans Affairs seeks a Health Care Analyst to independently analyze financial, utilization and management records for health care facilities and providers, including Medicare and Medicaid billing.

The Billing Unit within Fiscal Services manages claims processing for Medicare and Medicaid, with revenue exceeding $20 million annually. This full-time role in Rocky Hill offers growth, work-life balance and collaborative teamwork.

Qualifications

• Six (6) years of professional experience in financial management with some experience in health care management.
• 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.
• 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.
• 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.

Responsibilities

• Reviews materials to determine compliance with Connecticut General Statutes and agency regulations.
• Reviews and evaluates financial, utilization and management records of health care facilities and/or providers toward various ends.
• Determines action steps based on record analysis; prepares financial, narrative and statistical reports.
• Reviews findings and conclusions with audit staff and members of senior staff.
• Performs related duties as required.
• Reviews Certificate of Need applications for health care facilities and analyzes impact on other providers.

Skills

Financial management

Health care management

Interpersonal skills

Oral and written communication

Education

Bachelor's degree

Master's degree

Tools

Microsoft Office

Electronic Health Record System

Billing systems

Job description

Introduction

Do you have experience professional experience in financial management with some experience in health care management?

THE POSITION

The State of Connecticut, Department of Veterans Affairs (DVA) is now hiring for a Health Care Analyst to join their team! This position 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 health insurance providers which more closely aligns with the work performed in the position.

The Billing Unit within Fiscal Services is responsible for submitting the claims for both Medicare and Medicaid on behalf of our Skilled nursing facility. The revenue generated from these claims exceeds $20 million annually. This position places a critical supporting role in filing these claims.

HIGHLIGHTS

• ADDRESS: 287 West Street, Rocky Hill, CT
• UNIT: Fiscal Billing Services Department
• SCHEDULE: Full-Time, 40 Hours per Week, First Shift, Monday through Friday, 7:30am - 4:00pm

WHAT WE CAN OFFER YOU

• Professional growth and development opportunities
• A healthy work/life balance to all employees

DISCOVER THE OPPORTUNITY TO

• Be a part of a comprehensive team of caring professionals;
• Provide support that is passionate about improving the lives of those we serve;
• Assist our clients so they can achieve success;
• Make a difference in the public sector; and
• Work together in a collaborative team environment.

ABOUT US

For over 140 years, DVA has been caring for its veterans and their dependents. As a Department, we believe in 'serving those who have served.' This is accomplished through our: Office of Advocacy and Assistance, Residential Facility, Healthcare Center, and Cemetery and Burial Services.

• Residential Facility: offers temporary, supportive living with programming designed to return Connecticut Veterans to independent living in the community;
• Sgt. John L. Levitow Healthcare Center: a state-of-the-art medical facility that offers long-term care for veterans with chronic, disabling conditions who require 24-hour assistance.

When you walk through the doors of the Healthcare Center (HCC), one immediately feels a sense of community, comfort, and camaraderie. Our highly trained staff is dedicated to providing compassionate care to meet the unique needs of Veteran patients, built on the foundation of integrity, honor, and respect. We pride ourselves on fostering these qualities as we honor Veteran patients for their service and encourage the innate bond between them.

PURPOSE OF JOB CLASS (NATURE OF WORK)

In the Departments of Correction, Mental Health and Addiction Services, Public Health, Social Services, Veterans Affairs 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;
• Determines action steps based on record analysis;
• 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.
• DEPARTMENTS OF CORRECTION, MENTAL HEALTH AND ADDICTION SERVICES AND VETERANS AFFAIRS:
• Prepares, analyzes and evaluates budget, claims, expenditure, utilization, rate setting and/or revenue issues within behavioral health or a Skilled Nursing Facility;
• Analyzes General Assistance authorizations and expenditures, rate setting scenarios and new methodologies;
• May review patient eligibility coverage and make recommendations for claims;
• 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;
• health care industry;
• Skills
• 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

• 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.
• 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.
• 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.
• Successful completion of
• a Connecticut Careers Trainee program approved by the Department of
• Administrative Services may be substituted for the General Experience.

PREFERRED QUALIFICATIONS

• Experience with Current Procedural Terminology (CPT), International Classification of Diseases (ICD-10), Patient Driven Payment Method (PDPM), and Insurance Billing and Reimbursement practices
• Experience performing billing functions in a Skilled Nursing Facility setting
• Experience using Microsoft Office
• Experience managing patient trust fund accounts
• Experience using an electronic health record system

Conclusion

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.

ACKNOWLEDGEMENT

As defined by Sec. 5-196 of the Connecticut General Statutes, a job class is a position or group of positions that share general characteristics and are categorized under a single title for administrative purposes. As such, a job class is not meant to be all-inclusive of every task and/or responsibility.