State of Maryland

A Health Services Rate Analyst Trainee is the entry level of work setting rates hospitals charge for health services and auditing hospital records for compliance with established rates. Employees in this classification do not supervise other positions.

Employees in this classification receive close supervision from a Health Services Rate Analyst Supervisor.

Positions in this classification are evaluated by using the classification job evaluation methodology.  The use of this method involves comparing the assigned duties and responsibilities of a position to the job criteria found in the Nature of Work and Examples of Work sections of the class specification.

The Health Services Rate Analyst Trainee, Health Services Rate Analyst I and Health Services Rate Analyst II are differentiated on the basis of degree of supervisory control exercised by the supervisor over these employees.  The Health Services Rate Analyst Trainee learns to perform duties under close supervision.  The Health Services Rate Analyst I performs duties under close supervision at times and under general supervision at other times depending on the complexity of the specific duty being performed.  The Health Services Rate Analyst II performs the full range of duties and responsibilities under general supervision.

Learns to review financial data from hospitals for completeness, accuracy, validity and adequacy for rate setting purposes;

Learns to determine the scope and nature of analysis of financial data required to set reasonable rates to be charged for health services;

Learns to perform calculations to develop inflation factors, inpatient rate changes, price leveling factors and case mix adjustments on inflation adjustments;

Learns to apply appropriate rate setting methodologies required for inflation adjustments, guaranteed inpatient revenue adjustments and whole or partial rate reviews;

Learns to modify rate setting methodologies for special factors or circumstances such as rate reductions and changes in intensity factors;

Learns to prepare manual and computerized work papers to document the rate setting process;

Learns to discuss proposed rates with hospital officials, Physicians and health insurance officials to gather information and explain the basis of rate proposals;

Learns to present empirical evidence summarized into staff recommendations to the Health Services Cost Review Commission (HSCRC) on the effectiveness and efficiency of proposed rates;

Learns to prepare testimony and provide background information for presentation at formal and informal hearings to explain and defend rate reviews and analyses;

Learns to audit annual financial statements of hospitals;

Learns to assist with proposed spend downs for hospitals to bring health services rates down to reasonable levels;

Learns to interpret and apply HSCRC regulations and policies in the review of hospital rate proposals;

Performs other related duties.

Knowledge of generally accepted accounting principles, theory, procedures and methods;

Knowledge of generally accepted auditing standards;

Knowledge of cost accounting principles, theory, procedures and methods as related to the provision of health services;

Knowledge of business administration and management practices;

Ability to use computerized fiscal applications and software;

Ability to communicate effectively;

Ability to establish and maintain effective working relationships with HSCRC staff, Accountants, Auditors, data processing staff, Attorneys, hospital officials, Physicians and representatives of health insurance companies;

Ability to learn HSCRC rate setting methodologies;

Ability to learn to analyze and interpret hospital financial reports and statements;

Ability to learn to apply health services rate setting principles and methodologies;

Ability to learn to modify health services rate setting methodologies as needed to meet unusual circumstances;

Ability to learn to document and defend HSCRC rate setting proposals.

Experience: Six years of experience, four years of experience setting rates hospitals charge for medical services and auditing hospital records for compliance with established rates and two years of experience examining, analyzing and interpreting accounting systems, records and reports by applying generally accepted accounting principles or conducting financial audits that include elements for finance and compliance, economy and efficiency and program results.

Note: Candidates may substitute the possession of a Bachelor's degree in accounting, finance, economics, hospital administration or health care administration from an accredited college or university and two years of experience examining, analyzing and interpreting accounting systems, records and reports by applying generally accepted accounting principles or conducting financial audits that include elements for finance and compliance, economy and efficiency and program results for the required experience.

Class specifications are broad descriptions covering groups of positions used by various State departments and agencies. Position descriptions maintained by the using department or agency specifically address the essential job functions of each position.

This is a Skilled Service classification in the State Personnel Management System.  All positions in this classification are Skilled Service positions. Some positions in Skilled Service classifications may be designated Special Appointment in accordance with the State Personnel and Pensions Article, Section 6-405, Annotated Code of Maryland.

This classification is assigned to Bargaining Unit G, Engineering, Scientific and Administrative Professionals classes. As provided by State Personnel and Pensions Article, Section 3-102, special appointment, temporary, contractual, supervisory, managerial and confidential employees are excluded from collective bargaining. Additionally, certain executive branch agencies are exempt from collective bargaining and all positions in those agencies are excluded from collective bargaining.

This classification is one level in a Non-Competitive Promotion (NCP) series. NCP promotions are promotions by which employees may advance in grade and class level from trainee to full performance level in a classification series.  In order to be non-competitively promoted to the next level in a NCP series, an employee must: 1) perform the main purpose of the class, as defined by the Nature of Work section of the class specification; 2) receive the type of supervision defined in the class specification and 3) meet the minimum qualifications of the classification.