Occ. Code 1775300

 

 

SENIOR HEALTH CARE MANAGEMENT SYSTEMS ANALYST,

GRADE 18

1775300

ASSOCIATE HEALTH CARE MANAGEMENT SYSTEMS

 ANALYST,  GRADE 23

1775400

PRINCIPAL HEALTH CARE MANAGEMENT SYSTEMS  ANALYST,  

GRADE 27

1775500

CHIEF HEALTH CARE MANAGEMENT SYSTEMS ANALYST,

GRADE 29

1775700

 

 

New York State Department of Civil Service

 

Classification Standard

 

BRIEF DESCRIPTION OF CLASS SERIES

 

Health Care Management Systems Analysts work in the field of health care financing; conduct health services research, and work with outside groups to develop policy options and recommendations to implement health care delivery systems, including managed care and health care insurance programs, that contain health care costs while protecting access to quality health care services; implement new or refined systems; and perform evaluations of health care financing systems.

 

These positions are classified primarily in the Department of Health (DOH), but positions of Associate Health Care Systems Analyst are also classified in the Office of People with Developmental Disabilities (OPWDD) Main Office.

 

DISTINGUISHING CHARACTERISTICS

 

SENIOR HEALTH CARE MANAGEMENT SYSTEMS ANALYST:  full performance level; conduct health services research and work with outside groups to develop policy options and recommendations.

 

ASSOCIATE HEALTH CARE MANAGEMENT SYSTEMS ANALYST:  advanced performance level; develop and evaluate effective health care strategies and programs and identify broad health care concerns for appropriate analysis and suggested solutions.  May supervise lower level staff.

 

PRINCIPAL HEALTH CARE MANAGEMENT SYSTEMS ANALYST:  unit head; manage priorities and provide guidance and direction to subordinate Health Care Management Systems Analysts and other staff.

 

CHIEF HEALTH CARE MANAGEMENT SYSTEMS ANALYST:  managerial level, manage and direct multiple units; develop, implement, and evaluate health care funding mechanisms for various health care delivery settings.

 

RELATED CLASSES

 

Health Care Fiscal Analysts review data on the promulgation of the rates affecting hospitals, ambulatory or long-term care facilities, and analyze insurance rate computations to ensure consistency with reimbursement principles.  Such positions also perform detailed analysis of rate appeals.

 

Program Research Specialists perform research and analysis and carry out special studies related to agency programs.  Activities include collecting and interpreting data, and manipulating databases; evaluating programs, developing research procedures, and implementing research and evaluation plans, identifying trends through the analysis of data and conduct of impact studies; presenting findings; and developing recommendations for programmatic changes based on research or studies.

 

Health Planners research and analyze medical resources and health care needs, design and implement programs to address shortages, conduct health planning analyses, convene work groups to achieve improvements in health care quality, access, affordability and efficiency, promote health systems and public knowledge of health care, track and analyze legislation, draft regulations, and conduct special planning studies.

 

Economists research business marketing and labor market trends, usually in a recurring or continuing program, apply economic theory and methods in the systematic collection and analysis of economic information and in the preparation of statistical and narrative economic reports.

 

ILLUSTRATIVE DUTIES

 

SENIOR HEALTH CARE MANAGEMENT SYSTEMS ANALYST

 

Identify, research, and analyze financial issues important to health care providers.

 

·         Conduct surveys, studies, analyses, and health care modeling.

·         Write position papers and prepare reports, contracts, and proposals that impact on other programs within DOH.

·         Edit and validate health care financing and utilization information.

·         Respond to inquiries from legislative staff, federal agencies, providers, health care associations, other departments within the State, and consumers on health care reimbursement issues.

·         Prepare a wide range of presentation materials for internal and external stakeholders.

 

Review State and federal health care financial statutes, regulations, and policies. 

 

·         Identify pertinent issues and assess their financial impact.

·         Review and analyze federal Medicare and Medicaid health care reimbursement actions and their impact on the health care delivery system of New York State.

·         Review and analyze current reimbursement systems for compliance with Governor's program direction and suggest modifications.

·         Prepare reports on topics relating to health care that reflect current operations and upcoming trends in the health care industry.

·         Research and review other states' health care initiatives and prepare papers summarizing their operations.

 

Participate in the development, implementation, and evaluation of audit or health care services/financing programs using statistical tools and other computerized applications.

 

·         Develop and maintain information systems.

·         Facilitate and process data requests.

·         Perform data analysis.

·         Develop and oversee the implementation of management report and system documentation.

·         Assist in rate-setting methodology and the assessment of its costs based on an understanding of the financial condition of the health care plans that seek to participate.

·         Review, analyze, and negotiate premium rate proposals submitted by plans and report on findings.

·         Analyze and monitor the financial condition of health plans and statutory reserve requirements.

 

Calculate impact of health care delivery systems regarding reimbursement methodologies, and analyze third party reimbursement rates.

 

·         Design evaluation procedures by which cost effectiveness and efficiency of programs can be determined.

·         Participate in the study of health care coverage models and evaluate quality of care provided to participants in various benefit packages.

 

Participate in RFP (Request for Proposal) processes, develop program reviews and evaluations, and prepare recommendations.

 

·         Design and negotiate contracts, and monitor contract compliance.

·         Manage contracts with outside contractors to support reimbursement reform including monitoring of contract deliverables and deadlines for work products.

 

ASSOCIATE HEALTH CARE MANAGEMENT SYSTEMS ANALYST

 

May perform all of the duties of a Senior Health Care Management Systems Analyst.

Independently conduct surveys and research.

 

·         Assist in the development of regulations and policy to implement or refine health care financing systems.

·         Write position papers and prepare reports, contracts, and proposals that impact on other programs within DOH.

 

Act as a team leader.

 

·         May supervise subordinate staff.

·         Mentor and train new professional staff.

·         Develop and oversee the implementation of management report and system documentation.

 

Develop and evaluate effective health care strategies and programs.

 

·         Develop and maintain information systems.

·         Facilitate and process data requests.

·         Represent DOH in meetings with members of the hospital industry.

·         Design reports.

·         Perform data analysis.

 

PRINCIPAL HEALTH CARE MANAGEMENT SYSTEMS ANALYST

 

May perform all of the duties of lower Health Care Management Systems Analysts.

 

Function as a team or unit supervisor in managing unit priorities and directing the administration of the assigned health care programs.

 

·         Provide guidance and oversight to subordinate staff, and intervene and resolve problems as necessary.

·         Determine and oversee staff assignments. 

·         Approve leave, and track time and attendance.

·         Monitor and evaluate staff performance. 

·         Identify training needs and arrange for provision of training.

·         Manage and direct program activities by setting priorities and deadlines.

·         Manage unit priorities and convey policy and procedural guidance to staff.

 

Provide direction in the administration of the program and assure the achievement of policy objectives of State and federal statutes.

 

CHIEF HEALTH CARE MANAGEMENT SYSTEMS ANALYST

 

May perform all the duties of lower level Health Care Management Systems Analysts.

Function as head of multiple units, providing advice and guidance to staff and direct supervision to professional staff, including those in other disciplines.

 

·         Provide guidance, and oversight to subordinate staff, and intervene and resolve problems as necessary.

·         Determine and oversee staff assignments. 

·         Approve leave, and track time and attendance.

·         Monitor, and evaluate staff performance. 

·         Identify training needs and arrange for provision of training.

·         Manage and direct program activities by setting priorities and deadlines.

·         Manage unit priorities and convey policy and procedural guidance to staff.

 

Develop, implement, and evaluate health care funding mechanisms for various health care delivery settings.

 

·         Utilize both quantitative and qualitative research techniques and methodologies to study and evaluate health care financial systems.

·         Direct the administration of the assigned health care programs.

 

Evaluate health care financial systems and the financial impact of statutory or regulatory changes on the States health care industry.

 

·         Examine alternative funding techniques.

·         Develop effective management controls to implement and evaluate fiscal and program objectives. 

 

Represent DOH in meetings with members of the hospital industry.

 

MINIMUM QUALIFICATIONS

 

SENIOR HEALTH CARE MANAGEMENT SYSTEMS ANALYST

 

Open Competitive:  Bachelors degree and one year of general experience in conducting public policy research and analysis in finance; and one year of specialized experience in health services research in finance, design, implementation, and evaluation of programs in the health care financing field; or a bachelors degree and completion of a two-year traineeship.

 

Substitution:  a masters degree may substitute for the one-year of general experience.

 

ASSOCIATE HEALTH CARE MANAGEMENT SYSTEMS ANALYST

 

Open Competitive:  Bachelor's degree and one year of general experience in conducting public policy research and analysis in finance; and two years of specialized experience in health services research in finance, design implementation, and evaluation of programs in the health care financing field. 

 

Promotion: one year of permanent competitive service as a Senior Health Care Management Systems Analyst.

 

Substitution:  a masters degree may substitute for the one-year of general experience.

 

PRINCIPAL HEALTH CARE MANAGEMENT SYSTEMS ANALYST

 

Promotion: one year of permanent competitive service as an Associate Health Care Management Systems Analyst.

 

CHIEF HEALTH CARE MANAGEMENT SYSTEMS ANALYST

 

Promotion: one year of permanent competitive service as a Principal Health Care Management Systems Analyst.

 

 

 

 

 

Date:  6/13

 

 

 

 

NOTE: Classification Standards illustrate the nature, extent, and scope of duties and responsibilities of the classes they describe.  Standards cannot and do not include all of the work that might be appropriately performed by a class.  The minimum qualifications above are those which were required for appointment at the time the Classification Standard was written.  Please contact the Division of Staffing Services for current information on minimum qualification requirements for appointment or examination.