Senior Health Policy Analyst

Location: Boston, MA

Department: The Center for Health Information and Analysis

Type: Full Time

Min. Experience: Mid Level

CHIA's mission is to be the agency of record for Massachusetts health care information, to responsibly steward sensitive and confidential data, and to objectively report reliable and meaningful information about the quality, affordability, utilization, access, and outcomes of the Massachusetts health care system.

In fiscal year 2017, the Commonwealth spent over $1 billion on MassHealth Fee-for-Service (FFS) per diem payments to nursing facilities, serving older adults, as well as children and adults living with disabilities. CHIA’s Health Analytics and Finance (HAF) unit is seeking a Senior Health Policy Analyst to support the life cycle of rate development for Long Term Care (LTC) providers and programs. The Senior Health Policy Analyst will review facility cost reports, conduct data analysis, perform audits of financial statements, and other tasks for updating payment rates.

The Senior Health Policy Analyst will not only process, but also take a leadership role in the implementation of the FFS rates, which includes conducting analysis on LTC costs and utilization, reviewing other supporting financial documentation, and presenting recommendations to stakeholders. This position reports to the HAF unit’s Health Services Pricing Operations Manager.

Specifically, the Senior Health Policy Analyst will:

  • Calculate and implement rates of payments for nursing and residential care facilities through data analytics, financial reviews, written recommendations, and engagement with external stakeholders, including providers and other state agencies;
  • Learn all aspects of LTC pricing policy and, in collaboration with other team members, create a process sustainability program through written documentation;
  • Lead project teams and supervise staff as needed to accomplish project goals;
  • Balance annual Nursing and Resident Care Facility cost reports including direct keying of data into mainframe system;
  • Perform detailed cost analyses via desk review or field audit;
  • Assist managers and attorneys in researching and calculating nursing and residential care facility appeals.
  • Independently investigate and analyze issues regarding a particular provider or payer including the impact of program and pricing options.
  • Identify opportunities to improve process efficiency, proposing and implementing innovative solutions;
  • Ensure rates of payment are in compliance with Executive Office of Human Services (EOHHS) regulations and policies;
  • Serve as a subject matter expert to support a variety of financial and analytic projects across the unit and agency;
  • Participate in stakeholder meetings and training sessions with nursing and residential care  providers and other state agencies (the Executive Office of Health and Human Services, Department of Public Health, Department of Transitional Assistance, etc.);
  • Participate in cross-unit workgroups to enhance data management and analysis approaches;
  • Implement quality assurance protocols to ensure accurate results; and
  • Work independently as well as with team members in tracking completion of project components and meeting deadlines.

Preferred Qualifications:

The Senior Health Policy Analyst must be self-motivated, an analytical and strategic thinker, and possess creativity and intellectual curiosity. The Senior Health Policy Analyst should also be able to demonstrate:

  • Working knowledge of the Massachusetts health care system;
  • Effective communication skills with a demonstrated ability to synthesize analysis and conclusions in written reports and oral presentations
  • Proficiency using various software applications, including but not limited to, Microsoft Excel, Word, Access and PowerPoint, SAS, R, or other statistical analysis applications;
  • Ability to plan and execute an audit/review of the financial records for health care facilities and programs,
  • Ability to understand and explain the provisions of  laws, rules, regulations, policies, procedures, specifications, standards and guidelines,
  • Ability to clearly share knowledge and mentor Reimbursement System Analyst II’s
  • Ability to read and interpret financials statement, P&L’s and cost reports;
  • Knowledge of basic accounting principles and nursing and residential care facility payment systems,
  • Strong oral and written communication skills;
  • Excellent attention to detail;
  • Ability to lead workgroups;
  • Ability to work effectively both independently and in a team environment;
  • Ability to manage workload to simultaneously advance several projects with overlapping deadlines; and
  • Experience working with people from diverse backgrounds and experience levels.

 

Qualifications:

MINIMUM ENTRANCE REQUIREMENTS:

Applicants must have at least four years of full-time, or equivalent part-time, professional experience in accounting, business administration, public care planning or administration, public health policy or administration, the major duties of which included financial analysis of costs, expenses and revenue and/or the development, implementation and monitoring of the health care service delivery system and pricing methods.

Substitutions:

Any equivalent combination of the required experience and the substitutions below:

  • A Bachelor’s degree with a major in accounting, health care administration, public health or health services administration, accounting, business administration, business management, public policy, public administration, or economics may be substituted for a maximum of two years of the required experience.
  • A graduate degree with a major in accounting, health care administration, public health or health services administration, accounting, business administration, business management, public policy, public administration, or economics may be substituted for a maximum of two years of the required experience.

BARGAINING UNIT: 06 NAGE, Reimbursement Systems Analyst III

CHIA is an Equal Opportunity / Affirmative Action Employer.  Females, minorities, veterans, and persons with disabilities are strongly encouraged to apply.

If you have Diversity, Affirmative Action or Equal Employment Opportunity questions or need a Reasonable Accommodation, please contact Diversity Officer / ADA Coordinator: Tonya Bourassa 617-701-8127.

In compliance with federal laws, all persons hired will be required to verify identity and eligibility to work in the United States and to complete the required employment eligibility verification document form upon hire.

SPECIAL REQUIREMENTS: None.

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