Financial Analyst II

This position is exempt from the State Human Resources Act

This posting is for a pending vacancy, anticipated October 2024.

TELEWORK AVAILABILITY: We trust our employees to be self-motivated and successful in hybrid/remote roles; NC Department of Health and Human Services offers work from home options and variable work schedule flexibility for this position. 

Division of Health Benefits employees with an approved hybrid telework schedule are currently expected to work onsite at their assigned duty station at least 4 working days per month or more as needed for business operations.  Telework options are subject to change at the discretion of management. More information on this arrangement may be obtained at the time of interview.

This position's duty station is assigned to Dix Campus in Raleigh, North Carolina.

Position Summary

NC Medicaid strives to optimize the purchasing power of each state dollar in the quest to "buy health" efficiently for Medicaid beneficiaries. Division of Health Benefits' Finance Section analyzes national and state economic trends, changes in the health care market, and trends in Medicaid spending using proven budget and finance practices to prepare the Department and North Carolina for financial challenges that lie ahead.

The Provider Reimbursement section establishes CMS approved reimbursement methodologies and rates for the numerous Medicaid-covered health care services and administers the financial implementation of the 1915(b)(c) waiver, including financial monitoring and oversight of local management entities/managed care organizations (LME/MCOs). These teams also complete fiscal estimates associated with new or expanded services.

The analyst in this position will be the primary staff member responsible for managing the rate structure for Skilled Nursing Facility (SNF), Hospice, Personal Care Services (PCS) and Community Alternatives Program (CAP). This position will also serve as the main point of contact for all rate matters related to the Medicaid Direct and Managed Care. This position performs complex work and in-depth financial analysis to determine reimbursement rates.  This position's work also involves a wide variety of knowledge and interpretation of state and federal regulations in the management of assigned programs as well as drafting proposed modifications to regulations for changes to rate methodologies of respective programs.

Job Specific Responsibilities

• Compile, monitor and analyze cost report data for the purpose of setting and defending reasonable and adequate rates, controlling costs, and evaluating the strengths and weaknesses of the reimbursement methodologies.
• Study alternative reimbursement systems in order to develop and implement reimbursement methods that are the most effective and efficient in providing appropriate funding support to Medicaid providers within state budget constraints.
• Provide responses and guidance as needed to respective providers as well as follow-up on inquiries submitted by legislators, state auditors, and DHB management.
• Establish reimbursement rates for individual Medicaid providers implementing and managing fee schedule changes in accordance with the Division's reimbursement plans and federal regulations.
• Verify all appropriate rate and reimbursement methodology changes are completely functional within DHB systems to accommodate new rate structures and coordinate the appropriate communication externally and internally to other DHB sections who may be impacted by the change.
• Project and provide a cost impact analysis of changes in the rates, and coordinate with the budget to ensure appropriate funds are available to support the change in rates.
• Support analysis for proposed and final payment rules and prepare other ad-hoc financial reports based on data gathered or produced.

To receive credit for all of your work history and credentials, you must list the information on the application form. Any information listed under the text resume section or on an attachment will not be considered for qualifying credit. Qualified applicants must document on the application that they possess all of the following:

• Experience communicating effectively with internal and external stakeholders.
• Demonstrated ability to plan and organize work and be very flexible and adaptable to continually changing priorities.
• Proficient in Microsoft Office with intermediate to advanced skills in Microsoft Excel to include applied financial modeling analysis.
• Experience conducting financial and/or accounting data analysis, forecasting and/or modeling.
• In-depth knowledge of accounting theories and principles.

Management Preferences:

• Previous and proven work experience at Division of Health Benefits/NC Medicaid.
• Familiarity with relevant and current NC Medicaid operations.
• Rate setting experience or knowledge.

Some state job postings say you can qualify by an "equivalent combination of education and experience." If that language appears below, then you may qualify through EITHER years of education OR years of directly related experience, OR a combination of both. See oshr.nc.gov/experience-guide for details.

Bachelor's degree in accounting, banking, finance, business administration, economics, or related discipline from an accredited institution and 1 year of directly related experience or an equivalent combination of education and experience.

Degrees must be from appropriately accredited colleges or universities.

The North Carolina Department of Health and Human Services is an Equal Opportunity Employer.

Pre-employment criminal background checks are required for all positions with the Division of Health Benefits (DHB).

About NC Medicaid (Division of Health Benefits) 

The North Carolina Department of Health and Human Services (NCDHHS) works closely with beneficiaries, health care professionals, community leaders and advocacy groups; local, state and federal entities; and other community partners vested to improve the health and safety of all North Carolinians by providing essential human services. NCDHHS is one of the largest, most complex agencies in the state, with about 17,000 employees.

The Division of Health Benefits (DHB) within NCDHHS is committed to advancing innovative solutions that improve health, promote well-being and foster independence for all North Carolinians. DHB manages and oversees North Carolina Medicaid, NC Medicaid Managed Care and other programs that provide access to services and supports for parents, children, seniors, people with intellectual / developmental disabilities, and behavioral health, substance use and traumatic brain injury disorders. With a budget over $21 billion in state and federal funds per fiscal year, DHB ensures that more than 96,000 enrolled providers are reimbursed for delivering covered services to 2.9 million beneficiaries.

Realizing the strength of DHB lies in its employees, DHB remains dedicated in its efforts to create and maintain a diverse, equitable and inclusive workplace environment.

Application Process

Applicants are encouraged to apply for positions of interest, regardless of their current grade level and job classification. A pay increase may or may not result. Salary decisions are based on relevant education and experience, budget, and internal equity.

To be under consideration for this vacancy, all applicants must complete an online application using this link: https://www.governmentjobs.com/careers/northcarolina. If multiple applications are submitted to an individual posting, only the most recent application received prior to the posting close date will be evaluated for consideration.

Due to the volume of applications received, we are unable to provide information regarding the status of your application. To check the status of your application, please log in to your GovernmentJobs.com account. You will either receive a call or email to schedule an interview or an email notifying you when the job has been filled. For technical issues with your application, please call the NeoGov Help Line at 855-524-5627.  If there are any questions about this posting other than your application status, please contact us at Medicaid.Recruitment@dhhs.nc.gov.