State of Maryland

A Health Service Rate Analyst Supervisor is the supervisory level of work setting rates hospitals charge for health services and auditing hospital records for compliance with established rates.  Employees in this classification supervise lower-level Health Services Rate Analysts.

Employees in this classification receive general supervision from a manager in the Health Services Cost Review Commission (HSCRC).

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 Supervisor is differentiated from Health Services Rate Analyst, Advanced in that the Health Services Rate Analyst Supervisor has supervisory responsibility for lower-level Health Services Rate Analysts while the Health Services Rate Analyst, Advanced performs advanced duties as rate setting technical advisor to the HSCRC during the periodic review of contested hospital rate cases.

Plans, coordinates, supervises and evaluates the work of lower-level Health Services Rate Analysts and related support staff;

Develops and implements training programs for Health Services Rate Analyst staff;

Determines the need for modification of manual and automated systems to meet the specific fiscal requirements of the HSCRC and oversees the development and implementation of necessary modifications;

Maintains, updates, interprets and applies HSCRC laws and regulations to rate setting operations;

Develops and implements rate setting methodologies to meet new or proposed changes in health services practices;

Reviews and approves calculations to develop inflation factors, inpatient rate charges, price leveling factors and case mix adjustments;

Implements appropriate rate setting methodologies required for inflation adjustments, guaranteed inpatient review adjustments and whole or partial rate reviews;

Explains HSCRC policies and procedures to hospital officials and discusses options of settlement for non-compliance with these policies and procedures;

Presents recommendations of action to HSCRC on the effectiveness and efficiency of proposed rates;

Testifies at formal and informal hearings in order to explain and defend rate reviews and analyses;

Reviews and supervises audits of annual financial statements of hospitals for compliance with rate setting policies and procedures;

Recommends modification of HSCRC policies and procedures to comply with federal Medicaid waivers;

Represents the HSCRC on task forces, committees and other groups concerned with hospital rates;

May analyze hospital Certificate of Need applications before the Health Resources Planning Commission;

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;

Knowledge of health services rate setting methodologies;

Skill in analyzing and interpreting hospital financial reports and statements;

Skill in using computerized fiscal applications and software;

Skill in applying health services rate setting principles and methodologies;

Skill in modifying health services rate setting methodologies as needed to meet unusual circumstances;

Skill in documenting and defending HSCRC rate setting proposals;

Skill in communicating effectively;

Skill in establishing and maintaining effective working relationships with HSCRC staff, Accountants, Auditors, data processing staff, Attorneys, hospital officials, Physicians and representatives of health insurance companies;

Ability to plan, coordinate, supervise and evaluate the work of lower-level Health Services Rate Analysts and related support staff.

Experience: Nine years of experience reviewing, analyzing or negotiating rates hospitals charge for medical services and auditing hospital records for compliance with established rates.

Notes:

1. 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 five years of experience reviewing, analyzing or negotiating rates hospitals charge for medical services and auditing hospital records for compliance with established rates for the required experience.

2. Candidates may substitute the possession of a Master's degree in accounting, finance, economics, hospital administration or health care administration from an accredited college or university for five years of 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 not assigned to a bargaining unit as indicated by the designation of S (supervisor), M (manager), T(agency head), U (Board or Commission member), W (student), X (Used by agency or excluded by executive order), or Z(confidential).  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 therefore, all positions in those agencies are excluded from collective bargaining.