Cost Reporting & Rate Setting Manager

Overview

Under the general direction of the Assistant Director or designee, this role oversees cost reporting activities for the unit and calculates and sets payment rates for health care services. The position manages data analysts and consultants and produces work papers supporting yearly CMS and state cost reports for 18 state-operated facilities.

This role also oversees rate-setting activities for those facilities and recommends Medicaid claiming rates for community-based programs, including rehabilitative and home and community-based services authorized by an approved Medicaid Waiver.

Responsibilities

• Manage 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.
• Calculate unreimbursed costs at state-owned non-acute hospitals.
• Calculate and recommend 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 vendors’ work.
• Identify and apply best business practices.
• Collaborate with 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, including 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.

Reporting Requirements Supported

• CMS: 2552, 2540, 2088
• CHIA (State): 403, ICF, HCF-1
• OSD (State): UFR

Requirements

• 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

Compensation & Benefits

• Not specified in the provided description

Location

• Not specified in the provided description