State of Maryland

A Health Services Rate Analyst, Advanced is the advanced level of work setting rates hospitals charge for health services and auditing hospital records for compliance with established rates.  Employees in this classification perform advanced duties as rate setting technical advisor to the Health Services Cost Review Commission (HSCRC) during the periodic complete review of contested hospital rate cases.  Employees in this classification do not supervise other positions.

Employees in this classification receive general supervision from a Health Services Rate Analyst Supervisor or other designated administrator.

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

Reviews, independent from the HSCRC staff, hospital full rate applications and HSCRC staff recommendations coming before the Commission;

Reviews pre-filed testimony from all parties before formal hearings;

Examines, identifies and formally delineates contested issues of cases with the Hearing Officer and the Commission's Attorney;

Interprets HSCRC staff recommendations in relation to the long-term impact on HSCRC laws, regulations or policies;

Advises Commissioners during formal hearings regarding any technical questions on rate setting methods and techniques;

Drafts, in conjunction with the Hearing Officer and the Commission's Attorney, proposed decisions on contested issues;

Responds to inquiries from the full Commission regarding proposed decisions;

Prepares, in conjunction with the Commission's Attorney, final decisions on contested rate cases after all Commission concerns have been addressed;

Reviews financial data from hospitals for completeness, accuracy, validity and adequacy for rate setting purposes;

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

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

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

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

Prepares manual and computerized workpapers to document the rate setting process;

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

Presents empirical evidence summarized into staff recommendations presented to the HSCRC on the effectiveness and efficiency of proposed rates;

Prepares testimony and provides background information for presentation at formal and informal hearings in order to explain and defend rate reviews and analyses;

Audits annual financial statements of hospitals;

Assists with proposed spend-downs for hospitals to bring health services down to reasonable levels;

Interprets and applies HSCRC regulations and policies in the review of hospital rate proposals;

Performs other related duties.

Class Descriptions 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. 

Class Descriptions provide information about the Nature of Work, Examples of Work, General Requirements and Acknowledgements.  The Required Knowledge, Skills, and Abilities; Minimum Education and Experience Requirements; Special Requirements; and recruitment and testing procedures are set by the using agency.

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 collective bargaining.  Additionally, certain executive branch agencies are exempt from collective bargaining and all positions in those agencies are excluded from collective bargaining.