Job Specification Details

Experienced accountant familiar with Generally Accepted Accounting Principles and who is able to understand the information contained in audited financial statements. Uses complex regulations to determine the accuracy and the appropriateness of costs reported by nursing home providers and Private Nonmedical Institutions (PNMI). Follows detailed audit plan to complete desk reviews including adherence to standard auditing principals when creating audit files and work papers, while exercising good judgement and problem-solving skills. Follows detailed audit review process to perform an in-depth critical review of all the nursing home and PNMI auditors work and providing clear, organized feedback. Experienced accountant familiar with Generally Accepted Accounting Principles and who is able to understand the information contained in audited financial statements. Uses complex regulations to determine the accuracy and the appropriateness of costs reported by nursing home providers and Private Nonmedical Institutions (PNMI). Follows detailed audit plan to complete desk reviews including adherence to standard auditing principals when creating audit files and work papers, while exercising good judgement and problem-solving skills. Follows detailed audit review process to perform an in-depth critical review of all the nursing home and PNMI auditors work and providing clear, organized feedback. Performs accurate and well -planned analyses to support their findings and conclusions. Clearly communicates complex issues. Must effectively elicit the information required for reporting purposes. Complex audit and accounting analytical work involving the examination of provider submitted costs, financial statements, accounts, and records of Health Care facilities and Private Non-Medical Institutions (PNMI) subject to the jurisdiction of the Division of Rate Setting within the Agency of Human Services, and other programs assigned by the Secretary of Human Services. This position must be able to work independently and exhibit excellent judgement, problem-solving and analysis skills. Duties are performed under the supervision of the Rate Setting Manager or the Director of Rate Setting. All employees of the Agency of Human Services perform their respective functions adhering to four key practices: customer service, holistic service, strengths-based relationships, and results orientation

Applies complex regulations such as the Vermont Division of Rate Setting Rules, DVHA Medicaid Covered Services Rules, Centers for Medicare and Medicaid Publication 15 and Generally Accepted Accounting Principles. Performs reviews of cost reports submitted by nursing homes to determine allowable costs for Medicaid reimbursement pursuant to the various governing regulations. Examines provider accounting records such as the general ledger entries, invoices, detailed trial balance sheets and adjusting entries made by the CPA performing the required year-end audit. Works independently to perform critical original analyses. Tests data for accuracy by checking additional data sources. Creates work papers to show analytical work and present findings on Medicaid allowable costs. Assembles and organizes data to facilitate comparative cost analysis. Reviews the Division’s work papers for the correct application of the Division’s regulations regarding nursing home and PNMIs as they pertain to allowable cost findings and the rate setting processes. Participates at all stages of the appeal process when providers contest audit findings.  Drafts written decisions made in accordance with accounting standards and regulation. Reviews all the nursing home and PNMI auditors drafted decisions. Performs ad hoc analyzes of budgets of new facilities to determine a budget Medicaid rate. Determines new asset bases related to the allowed step-up of basis upon the sale of a nursing facility. Reviews all the nursing home auditors analysis. Designs and performs special purpose provider audits as assigned using knowledge of the Division’s  regulations, GAAP, governmental accounting principles, generally accepted audit practices and other state and federal standards and requirements. Review and analyze the nursing home rate adjustment requests. Review all the nursing home auditors work on rate adjustments. Review and analyze the PNMI rate adjustment requests and the Extraordinary Financial Relief (EFR) requests. Review the PNMI auditors work on rate adjustments and EFR Evaluates the fiscal effect of proposed regulatory changes. Prepares written narratives to present and formalize the detailed results of analyses. Conducts on-site reviews of nursing home and PNMI financial records as required. Attends meetings with PNMI Placement Authorizing Departments when necessary. Performs other special studies, reports and analyses as assigned. Shares information and expertise with team members by providing training and coaching to the Medicaid Residential Program Auditor, Health Facility Auditor IIs and Rate Support Specialist.  Assists in training newly hired audit staff.

Duties are performed in an office setting or hybrid work environment and occasionally at a provider's facility. Significant pressure from deadlines is present. Incumbents should have a private means of transportation available as some travel may be necessary. Requires significant tact and persistence to complete the review work.

Thorough knowledge of generally accepted accounting and auditing practices, particularly as they apply to the health care industry.

Ability to understand, use and explain complex regulations and calculations to others.

Ability to interpret and apply generally accepted accounting principles and theories to organizations.

Ability to manage a heavy workload and work with a high degree of independence to meet goals and deadlines.

Ability to review the work papers and findings of professional accounting and auditing personnel.

Knowledge of internal financial control systems.

Intermediate level knowledge and experience with Excel and Word.

Ability to detect and define accounting and reporting irregularities with and give recommendations on effective corrective measures.

Ability to design and adapt auditing procedures as needed for the review of large health care organizations.

Ability to establish and maintain effective working relationships.

Ability to understand complex concepts and data relationships.

Ability to assess data and draw appropriate conclusions.

Ability to assess project objectives, procedures and accomplishments and to recommend necessary and desirable modifications.

Ability to prepare and present comprehensive, analytical reports, oral and written.

Ability to present information and lead a discussion of complex subject matter and/or processes in such a way that those participating in meetings can get a clear understanding of the subject or process concerned.

Ability to work independently or in a team.

Ability to deal with controversial matters in a tactful manner.

Ability to perform job duties within the framework of the four key practices of the Agency of Human Services: customer service, holistic service, strengths-based relationships and results orientation.

Master's degree in Business Administration or accounting AND two (2) or more years of experience in a finance related field.

OR

Bachelor's degree in Finance or Accounting AND three (3) or more years of finance, accounting or auditing experience.

OR

Bachelor's degree in any discipline supplemented by 15 credit hours in accounting AND four (4) or more years of finance, accounting or auditing experience.

OR

Certified Public Accountant (CPA) (license does not need to be in force).

Experience in a health care or regulatory environment.

Note: There will be a skills assessment test to be taken at the Division as part of the hiring process.

Candidates must pass any level of background investigation applicable to the position. In accordance with AHS Policy 4.02, Hiring Standards, Vermont and/or national criminal record checks, as well as DMV and adult and child abuse registry checks, as appropriate to the position under recruitment, will be conducted on candidates, with the exception of those who are current classified state employees seeking transfer, promotion or demotion into an AHS classified position or are persons exercising re-employment (RIF) rights.