LTC Reimbursement Analyst Details

LTC Reimbursement Analyst

State of Indiana - Indianapolis, IN

Employment Type : Full-Time

Grow your career with the State of Indiana! With more than 50 executive branch agencies, the State of Indiana is a diverse workforce offering employees stimulating and challenging projects across a broad scope of career opportunities. As a State of Indiana employee, you impact the well-being of Indiana’s communities every day.

At the State of Indiana, we don’t just talk about diversity and inclusion – Our goal is to create a welcoming, accessible, and equitable workplace, with a workforce that is representative of the State of Indiana population. As a proud equal opportunity employer, reasonable accommodations may be available to enable individuals with disabilities to interview and to perform the essential functions of a role.

About the Family & Social Services Administration:

The Office of Medicaid Policy and Planning (OMPP) is a division within the Family and Social Services Administration, which receives around 13 percent of the state's budget to ensure vital health care coverage to approximately 1 in 5 Hoosiers. OMPP strives to build programs and processes that enable Hoosiers to live in fully engaged communities and reach their greatest emotional, mental and physical well-being. Our mission is to support individual and community well-being with effective and efficient programs, remarkable collaborations, measurable impact on individuals and communities, and an energized staff that is fully engaged with this mission.

Salary: The annual minimum starting salary for this position is $ 41,574.00. Salary may be commensurate with relevant experience/education.

The working title for this position is Long Term Care Reimbursement Analyst.

Next level benefits at the State of Indiana are here! Be sure to review our expanded benefit package offerings below.

As the Program Director, you will be responsible for administering a program within a state agency and serve as the specialist in a specific area. In this position, you will utilize education, consultation, cooperative programming, and coordination to accomplish goals. This role serves as the subject matter expert on Long Term Care (LTC) reimbursement for Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICFs/IID), Community Residential Facility for the for the Developmentally Disabled (CRF/DD), home health agencies, hospice agencies, and state operated facilities (SOF).

The essential functions of this role are as follows:

• Create, update and implement ICF/IIDs, CFR/DDs, hospice, home health, and state operated facilities procedures for rate setting and rate verification during the effective period for each type of rate.
• Review ICF/IIDs, CFR/DDs, home health agencies, hospice agencies, and SOF rates set by rate setting contractor.
• Monitor long term care rate setting contractor on an ongoing basis to insure contractual obligations are fulfilled to ensure compliance with proper application of rules, regulations, policies and procedures.
• Accurately draft and submit all State Plan Amendments regarding ICF/IIDs, CFR/DDs, hospice, and home health agencies.
• Conduct ongoing evaluation of the home health, hospice, and state operated facilities desk reviews to ensure penalty letters, and provider correspondence is completed by the contractor within established timelines based on OMPP rules, regulations, Indiana Code, and Indiana Administrative Code.
• Draft and submit all administrative rules regarding ICF/IIDs, CFR/DDs, hospice, and home health agencies.
• Facilitates integration and coordination with other areas in OMPP, specifically nursing facility and acute care reimbursement and policy.
• Provides correct responses to questions regarding ICF/IIDs, CFR/DDs, home health agencies, hospice agencies, and SOFs reimbursement policy to stakeholders (state personnel, provider, members, and general public).
• Recommend changes to reimbursement based on changing landscape of the long term care industry, as well as, state and federal regulations.
• Provide assistance on other reimbursement projects as is necessary to fulfill agency and state objectives.
• Create and/or review bulletins and banners to inform providers of reimbursement or program changes as needed.
• Review potential PACE provider applications, participating in facility reviews, and ongoing monitoring of PACE organizations. Coordinate with State agency staff, Centers for Medicare and Medicaid Services (CMS), State contractors, and potential providers to insure compliance with Federal and State guidelines
• Analyze, review, and approve reimbursement rates for all hospice agencies, home health agencies, ICFs/IIDs and CRF/DDs, and State Operated Facilities in Indiana.
• Assist with drafting, reviewing and researching issues, pertaining to home health, hospice and State Operated Facilities (SOFs) related to the development of State Plan Amendments, state statues, and administrative code.
• Review PACE reimbursement rates as provided by the State’s actuary.
• Project Lead on PACE – Continue to organize, develop and implement the Program of All-Inclusive Care for the Elderly (PACE) in Indiana. Coordinate with State agency staff, Centers for Medicare and Medicaid Services (CMS), State contractors, and potential providers to insure compliance with Federal and State guidelines. Duties include but are not limited to reviewing potential provider applications, participating in facility reviews, and ongoing monitoring of PACE organizations.

The job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee. Other duties, responsibilities and activities may change or be assigned at any time.

This person must have the following requirements to be considered for employment:

• Four (4) years of experience in program coordination, development, implementation, or related experience; or a combination of experience and accredited college training may be considered.
• The ability to communicate complex information both orally and in writing required.
• Knowledge of Medicaid policies and procedures concerning long term care reimbursement, knowledge of federal and state law, regulations, and state plan is strongly desired.
• Proficient in Microsoft Office (Excel, Word, and PowerPoint) and general database tools
• Ability to plan, initiate, and properly execute program goals and initiatives
• Ability to work well with external stakeholders to address any questions or concerns
• Ability to critically assess effectiveness of work
• Ability to travel

Benefits of Employment with the State of Indiana:

The State of Indiana offers a comprehensive benefit package for full-time employees which includes:

• Three (3) medical plan options (including RX coverage) as well as vision and dental plans;
• Wellness program (offers premium discount for the medical plan and gift cards);
• Health savings account, which includes bi-weekly state contribution;
• Flexible work scheduling options, including the potential for hybrid remote work for employees whose work may be performed outside state facilities;
• Deferred compensation 457B account (similar to 401k plan) with employer match;
• Two (2) fully-funded pension plan options;
• A robust, comprehensive program of leave policies covering a variety of employee needs, including but not limited to:
  • 150 hours of paid new parent leave;
  • Up to 15 hours of paid community service leave;
• Combined 180 hours of paid vacation, personal, and sick leave time off;
• 12 paid holidays, 14 on election years;
• Education Reimbursement Program;
• Group life insurance;
• Referral Bonus program;
• Employee assistance program that allows for covered behavioral health visits;
• Qualified employer for the Public Service Loan Forgiveness Program;
• Free Parking for most positions;
• Free LinkedIn Learning access;

Equal Employment Opportunity:

The State of Indiana is an Equal Opportunity Employer