Financial Policy Analyst

Description

We have a hybrid work arrangement.

 EOE: race/color/religion/sex/sexual orientation/gender identity/national origin/disability/vet

 JOB SUMMARY

The Financial Policy Analyst performs policy and data analysis and reimbursement research to support policy analysis and advocacy initiatives for the organization. This position collects, analyzes, interprets, and models data on a variety of reimbursement topics to support member hospitals, including, but not limited to, Medicare and TennCare reimbursement.

This position assists with the development of corporate and division goals on financial, reimbursement, and federal advocacy issues and the development of programs, education, and other operations to ensure effective accomplishment of the association’s goals.

ESSENTIAL FUNCTIONS OF THE JOB: 

1. The ability to adapt to a changing work environment and meet challenges presented throughout the day.

2. Assists management in understanding Medicaid regulatory issues, including reimbursement, Disproportionate Share Hospital (DSH) audits and payments, Tennessee Hospital Investment Program (HIP), waiver amendments, program changes, and other hospital-related issues.

3. Analyzes the impact of potential changes to regulatory requirements on hospital reimbursement and methodologies, including, but not limited to, Medicare and Medicaid.

4. Prepares draft letters and position statements for the organization on proposed rules and regulations in representation of THA’s adopted position(s) on proposed healthcare policy and payment system changes to state and federal regulatory agencies, including the Centers for Medicare and Medicaid Services (CMS), the Internal Revenue Service (IRS), TennCare waiver proposals, and others.

5. Develops and maintains a working knowledge of Medicare reimbursement systems in order to make strategic recommendations for maximizing program benefits, including, but not limited to, the Medicare Inpatient Prospective Payment System (IPPS), the Medicare Outpatient Prospective Payment System (OPPS), and others.

6. Prepares information for and responds to member requests for assistance on various issues, such as patient accounting, chargemaster, charity policies, and discounts to the uninsured.

7. Assists in the development of education programs and other resources to support members on financial initiatives.

8. Collaborates with management in the design, study, and research of information related to policy development and advocacy positions for member hospitals and the organization.

9. Keeps abreast of current healthcare policy and reimbursement issues affecting hospitals at the state and national levels.

10. Maintains a positive relationship with external agencies and governmental entities, including the CMS national and regional offices; the Medicare Administrative Contractors (MACs); and the State Medicaid agency, TennCare.

11. Provides technical assistance to committees/taskforces related to healthcare policy and reimbursement to support the organization’s policy development of initiatives and goals. 

12. Provides technical assistance to THA management responsible for federal and state lobbying efforts.

13. Supports and advocates the organization’s communication agenda with timely articles that analyze issues related to hospital finances and policies.

14. Provides courteous and prompt service to all internal and external clients.

15. Prioritizes and addresses requests and assignments in a professional manner.

16. Maintains a high level of confidentiality with member and employee information, as well as political and financial data.

17. Must be available for out-of-town travel approximately 10 percent of the time, be able to drive an automobile and maintain a valid driver’s license.

18. Must be available in the office during regular office hours, unless hybrid work arrangement is in place or job responsibilities require otherwise. 

MARGINAL JOB FUNCTIONS

Performs other duties as required.

ORGANIZATIONAL STRUCTURE: (Positions reporting directly to this position, if any, and their areas of responsibility)

None

GUIDANCE & DIRECTION: (Policies, precedents or procedures that guide this work)

1. Guidance and direction are provided by the Senior Director of Financial Policy, THA SVP of Finance and Reimbursement, and THA Board of Directors to achieve THA mission and goals.

2. Medicare and Medicaid laws, regulations, program memorandums, transmittals, and the guidance published in the Federal Register.

3. Laws, rules, and regulations of the State of Tennessee.

4. Federal laws, rules, and regulations, including the IRS tax code.

5. Generally Accepted Accounting Principles (GAAP) and the Governmental Accounting Standards Board (GASB) requirements.

6. Company policies and procedures.

Requirements

Educational and Experience Requirements Needed to Perform the Duties of the Job:

Requires either:

A minimum of three years of experience in a healthcare finance or related position as well as a Bachelor’s degree in finance or accounting or Certified Public Accountant (CPA)

Or

A minimum of five years of experience in hospital finance or related position and a Bachelor’s in Business Administration (BBA) or a related field.

Licensing or Other Special Certifications Required:

See the preceding section.  

Skills Required to Perform the Duties of the Job:

1. The ability to create, update, and/or modify complex Microsoft Excel workbooks allocating payments accurately per state and/or federal rules, regulations, or policies.

2. The ability to determine and prioritize the impact of many complex reimbursement issues and provide analyses and evaluations in understandable formats.

3. Independent judgment and organizational and planning skills to prioritize and develop initiatives and programs to meet determined needs.

4. The ability to determine whether a proposed rule, regulation, or law is of concern to THA members, whether it accomplishes a worthwhile objective, and whether it is unduly burdensome.

5. The ability to understand and interpret the financial operations of healthcare institutions, the law, rules and regulations in which hospital finance operates in, Medicare and Medicaid payment structures, financial data analysis, and healthcare financial reports, such as Medicare Cost Reports and the Tennessee Joint Annual Report for Hospitals.

6. The ability to make effective presentations before large groups.

7. The ability to maintain good working relationships with THA staff and membership and state and federal regulators.

8. Excellent communication skills, both oral and written.

9. Advanced computer skills required, including Microsoft Word, Excel, PowerPoint, and Outlook.