State of Connecticut Executive Branch

In the Departments of Developmental Services, Mental Health and Addiction Services, Public Health, Social Services or the Office of the State Comptroller this class is accountable for performing the most complex tasks in the analysis of financial, utilization and management records of health care facilities and/or providers or health insurance providers.

Works under the limited supervision of a Principal Health Care Analyst or other employee of higher grade.

May lead Health Care Analysts and other staff as assigned; may act as lead analyst on projects of lesser magnitude.

• Performs the most complex duties in the review of materials to determine compliance with requirements contained in Connecticut General Statutes and agency regulations;
• Assists in development of procedures, documentation references and computer programming and data base management to provide efficient and effective use of staff resources;
• Reviews and evaluates financial, utilization and management records of health care facilities and/or providers toward various ends;
• Prepares complex financial, narrative and statistical reports;
• Reviews findings and conclusions with senior staff;
• Conducts research and analysis as needed for special projects;
• Provides staff training and assistance;
• Performs related duties as required.

• Analyzes complex provider enrollment applications and required supporting documentation which includes, but not limited to: financial reports to demonstrate solvency, budget, line of credit, entity incorporation papers, certificates of insurance, business and strategic plans, Board of Directors or Advisory Board composition and their biographical summaries and clinical credentials, mission statement, organizational charts, letters of references, background check information and provider's policies and procedures;
• Arranges for the Qualified Provider Committee to review acceptable provider application and credentials and to interview applicants recommended as a qualified provider;
• Performs related duties as required.

• Analyzes and evaluates complex budget, expenditure, utilization, rate setting and/or revenue issues within behavioral health programs;
• Prepares reports of findings for decision and policy making purposes;
• May prepare cost-based rate proposals for provider services;
• Performs related duties as required.

• Reviews various complex health care facility and/or provider Certificate of Need applications;
• Analyzes impact of proposals on other health care providers in Connecticut;
• Prepares necessary related written documents and assists employees of higher grade by drafting decisions;
• Reviews revenue, expense, uncompensated care and utilization data to measure the financial condition of hospitals and to provide data for decision and policy making;
• Performs related duties as required.

• Analyzes and evaluates complex budget, expenditure, utilization, reimbursement rate setting and/or revenue issues within social services programs, including Medicaid;
• Participates in public hearings and assists senior staff in conferring with representatives of facilities and outside experts with respect to issues;
• Interacts, under guidance, with Office of the Attorney General in any agency litigation including preparation of complete court records and substantive writing of technical issues for inclusion in legal brief;
• May review complex Certificate of Need applications for nursing facility, residential care homes and ICF/ID development;
• Performs related duties as required.

• Analyzes complex health care financial and utilization data for state employees and retirees;
• Analyzes and evaluates health insurance plans;
• Answers inquiries and assists in processing appeals on health care benefit issues for state employees and retirees;
• Performs related duties as required.

• Considerable knowledge of principles and practices of financial management including organization, administration, management, finance, budgeting, auditing and accounting;
• Knowledge of health care industry;
• Skills
  • interpersonal skills;
  • oral and written communication skills;
• Considerable ability in interpretation and analysis of complex financial, statistical and technical data;
• Ability to utilize computer software.

Seven (7) 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.

• College training 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.

This replaces the existing specification for the class of Associate Health Care Analyst in Salary Group AR 25 approved effective October 18, 2019. (Reviewed for content, revised to modernize format and add an Acknowledgment section) Final No. 24-022