Tentative Classification Standards issued by the Division of Classification & Compensation are shared with the operating agencies of State government for their consideration and comment. Accordingly, this document that you are viewing is subject to change and will be issued in final form at the completion of the review period.

New York State Department of Civil Service

Division of Classification & Compensation

 

Tentative Classification Standard

 

Occ. Code    0230300

 

Senior Health Care Fiscal Analyst, Grade 18             0230300

Associate Health Care Fiscal Analyst, Grade 23            0230400

Principal Health Care Fiscal Analyst, Grade 27            0230500

Chief Health Care Fiscal Analyst, Grade 29            0230600

 

 

Brief Description of Class Series

 

Positions in this title series perform a range of specialized activities related to the calculation and maintenance of Medicaid reimbursement rates, and the review and analysis of financial information, including Consolidated Fiscal Reports (CFR) from health care providers. Incumbents review and analyze cost and statistical data reported by health care providers; complete financial and statistical analysis of health care financing plans, programs, and methodologies; conduct financial feasibility studies; calculate Medicaid rates; and resolve health care provider rate appeals. 

 

Positions are classified at the Department of Health, Office of Mental Health, Office for People With Developmental Disabilities, and Office of Addiction Services and Supports.

 

 

Distinguishing Characteristics

 

            Senior Health Care Fiscal Analyst: full performance level; reporting to a higher-level Health Care Fiscal Analyst or finance title, reviews and evaluates financial information; analyzes health care financing plans, programs, and methodologies; conducts financial feasibility studies; and calculates Medicaid reimbursement rates and resolves rate appeals.

 

            Associate Health Care Fiscal Analyst: first supervisory level; reporting to a higher-level Health Care Fiscal Analyst or finance title, supervises Senior Health Care Fiscal Analysts and/or other professional staff, and leads financial evaluation and analysis activities for a team.  

 

            Principal Health Care Fiscal Analyst: second supervisory level; reporting to a Chief Health Care Fiscal Analyst, Health Care Financing Program Manager, or other manager, supervises Associate Health Care Fiscal Analysts and other professional staff, and directs financial evaluation and analysis activities.

 

Chief Health Care Fiscal Analyst: managerial level; supervises multiple Principal Health Care Fiscal Analysts that direct teams of lower-level Health Care Fiscal Analysts and other staff; oversees financial evaluation, analysis, and rate setting activities; and plans and directs work for assigned work units.

 

 

Illustrative Tasks

 

            Senior Health Care Fiscal Analyst

 

Develops, reviews, and/or analyzes cost and statistical data, and financial reports submitted by health care providers and insurance plans.

 

·         Reviews financial information accompanying contracts, construction applications, reports, and other operational documents for financial feasibility and impact on Medicaid reimbursement rates.

 

·         Develops CFRs for State-operated programs.

 

·         Tracks and ensures that CFRs are filed timely; conducts desk audits to ensure accuracy of filings; and follows-up on late reports.

 

·         Reviews budget proposals for programs, contracts, grants, and solicitations for consistency with financial requirements.

 

·         Ensures quarterly statistical and ancillary financial information is accurately reported; identifies and addresses deficiencies; determines impact of incorrect reporting and communicates requirements to health care providers. 

 

·         Reviews billing processes to determine compliance with rules, and identifies and implements billing system edits and process changes in conjunction with information technology staff.

 

·         Conduct on-site readiness and operational evaluations of providers and health care plans to ensure financial compliance. 

 

·         Consults with agency audit staff on accounting issues requiring comprehensive review.

 

Performs financial and statistical analysis of health care financing methodologies to assess viability.  

 

·         Reviews statutory and regulatory requirements and amendments, assesses their impact on existing heath care financing systems and models, and drafts reports documenting impacts and required system billing changes.

 

·         Researches new health care financing methods to determine viability, and reviews existing methods to assess effectiveness and modification possibilities.

 

Conducts financial feasibility studies of health care provider capital projects and financial agreements.

 

·         Analyzes financial documents and assesses need and availability of capital, operating costs, revenues, and other considerations.

 

·         Reviews proposals for consistency with operating plans, expansion criteria, sound fiscal practices, character and competence of operator, and overall fiscal viability and cost effectiveness of proposals.

 

Provides technical assistance to budget and fiscal management, treatment, field office, and/or local government staff in the monitoring of health care provider revenues, fiscal planning needs, and cost reports.

 

Oversees financial databases for assigned program areas.

 

Performs Medicaid rate setting activities.

 

·         Calculates and updates Medicaid reimbursement rates by reviewing and analyzing relevant information consistent with applicable laws, rules, and regulations.  

 

·         Reviews and analyses requests for rate adjustments and appeals.

 

·         Assists upper-level Health Care Fiscal Analysts and other staff in developing specialty rates.

 

Resolves health care provider audit and rate appeal issues.

 

·         Develops necessary information and analyses to resolve outstanding financial issues.

 

·         Communicates verbally and in writing with providers regarding reimbursement rate adjustments.

 

·         Resolves questions raised by health care providers and outside auditors relative to assigned reimbursement rates.

 

·         Reviews audit reports from the Office of the Medicaid Inspector General and other entities to determine impact on assigned health care providers and any changes to reimbursement rates or systems.

 

·         Reviews rate appeals from health care providers to determine merits, and responds in writing to providers regarding appeal outcomes.

 

·         Communicates with outside audit firms to provide required information, and reviews findings to determine impact on assigned programs. 

 

May supervise lower-level staff assigned to the program area.

 

            Associate Health Care Fiscal Analyst

 

Supervises a team of Senior Health Care Fiscal Analysts and other staff engaged in financial analysis and review, and rate setting activities.

 

Provides technical assistance to budget and financial management, treatment, field office, county, and health care provider staff on fiscal and rate setting issues.  

 

Drafts and reviews reports from staff, including CFRs, and ensures that reports are submitted by agencies and health care providers within required timeframes; and provides technical assistance to providers and State programs to resolve CFRs and other reporting issues.  

 

            Principal Health Care Fiscal Analyst

 

Supervises teams of Associate Health Care Fiscal Analysts and other staff engaged in financial analysis and rate setting activities; and develops unit policies, procedures, and guidelines.

 

Manages financial analysis and reporting activities to support health care finance reforms, revenue generation, Medicaid redesign, and other initiatives; and directs research of alternative health care financing methodologies to support system improvements.

 

Develops and implements agency-specific health care financing and revenue projects, and reports progress to upper-level staff; and collaborates with State agency staff, health care providers, and local governments on assigned projects.

 

Chief Health Care Fiscal Analyst

 

Oversees multiple Principal Health Care Fiscal Analysts that supervise large teams of lower-level staff.

 

Plans, assigns, and directs the work of multiple work sections, and manages rate setting, financial analysis, and evaluation activities.

 

Makes determinations on rate setting requests and approves the work of lower-level staff. 

 

Directs system reform projects involving coordination with State and local providers, other State agencies, and federal partners.

 

 

Minimum Qualifications

 

Senior Health Care Fiscal Analyst

 

Open Competitive: bachelor's or higher degree in accounting, auditing, business administration, economics, finance, healthcare administration, hospital administration, or public administration, including or supplemented by 12 semester credit hours in accounting and/or auditing; and 6 additional semester credit hours in statistics, economics, accounting, and/or auditing; and completion of a two-year traineeship.

 

            Associate Health Care Fiscal Analyst

 

Promotion: one year of service as a Senior Health Care Fiscal Analyst.

 

Principal Health Care Fiscal Analyst

 

Promotion: one year of service as an Associate Health Care Fiscal Analyst.

 

Chief Health Care Fiscal Analyst

 

Promotion: one year of service as a Principal Health Care Fiscal Analyst.

 

 

 

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.

 

 

Date: 9/2020

 

 

AJR