PSG Hiring for SNF and HHA Payment Methodology Consultant at Washington, DC Full Time

The Public Sector Solutions Group (PS2G) is a technology-driven company that provides innovative solutions to state and local government partners which enable them to achieve their performance goals and better service constituents at the most critical point of need. Our team leverages deep knowledge of government programs, IT management systems, application development, and specialized technical expertise to help clients achieve their performance goals while ensuring audit compliance and ing for federally funded agencies.

The Rate Methodology Analyst Contractor will be responsible for analyzing rates, payment policies, and payment methods for Skilled Nursing Facilities and Home and Community Based services, and other provider types as required. The main focus of this contract is to assist DHCF in the transition of RUGS IV to PDPM systems to determine Skilled Nursing Facility acuity levels, ensure rate methodologies are equitable to support quality services rendered, as well as establish policy and procedure and train the trainer. The candidate should possess knowledge and understanding of current Rate Methodologies for skilled nursing facility and professional provider services and utilize that knowledge to assist the District in analyzing and updating that rate methodology to align with current Medicaid policies and priorities. Additionally, the contractor must establish policy and procedures to ensure proper oversight of the Skilled Nursing Facility rate methodology and provide leadership training in the oversight and implementation of the skilled nursing facility rate methodology.

Responsibilities:

• Assist DHCF with the analysis of current and prospective rate methodologies
• Function as a subject matter expert on behalf of ORRFA
• Establish a work plan for assignments provided by ORRFA
• Review options available to transition from RUGS IV to determine Nursing Home Acuity level
• Analyze and update the Rate Methodology for skilled nursing facility and professional provider services
• Establish policy and procedures to ensure proper oversight of the Skilled Nursing Facility rate methodology
• Provide leadership training in the oversight and implementation of the skilled nursing facility rate methodology
• Assist DHCF in updating the hospital rate methodologies to align with future transitions of participants
• Meet with rate methodology stakeholders as directed by DHCF
• Meet with ORRFA staff on a bi-weekly basis to provide a status of work based on the established work plan

Requirements:

• Background in oversight and management of the establishment of institutional facility rate setting for public health care
• Payment methodology policy experience working with Medicaid agencies in the District of Columbia
• Expert knowledge of the Medicaid program and its role in financing Skilled Nursing Facilities and Home and Community Based services
• Extensive experience analyzing healthcare claims, conducting fiscal impacts of changes as necessary and providing payment policy recommendations to DHCF based on findings of said analyses
• Possess a full understanding of DHCF’s current payment policies for skilled Nursing Facility services, methodologies, and analysis as well as Home and Community Based Services
• Strong analytical and writing skills and the ability to evaluate and synthesize information develop necessary plans and assess programs, activities, and services
• Excellent interpersonal skills
• Extensive experience serving Medicaid beneficiaries
• Experience in analyzing Patient Driven Payment Models (PDPM) to determine efficiency and effectiveness
• Experience in analyzing cost s and ability to audit financial data provided by Medicaid providers
• Experience in writing policy and procedures for a healthcare provider or system.

Job Types: Full-time, Part-time, Contract, Temporary

Pay: $30.00 – $60.00 per hour

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Standard shift:

• Day shift

Weekly schedule:

• Monday to Friday

Ability to commute/relocate:

• Washington, DC 20001: Reliably commute or planning to relocate before starting work (Required)

Work Location: Hybrid remote in Washington, DC 20001