NOTE: If you are a current NC State Government employee, you will not be considered for a temporary assignment. Temporary Solutions cannot accommodate dual employment.

The position is located in Raleigh – Wake County. There are no leave or retirement benefits offered.

TELEWORK AVAILABILITY: We trust our employees to be self-motivated and successful in hybrid/remote roles; NC Department of Health and Human Services offers work from home options and variable work schedule flexibility for this position.

The Division of Health Benefits requires temporary workers with an approved hybrid telework schedule to work onsite at their assigned duty station at least 8 working days per month. More information on this arrangement may be obtained at the time of the interview.

Hourly Rate: $19.00 to $26.00
(Hourly Rates are based on education, experience, equity, and budget)

Position Overview:
NC Medicaid strives to optimize the purchasing power of each state dollar in the quest to “buy health” efficiently for Medicaid beneficiaries. Division of Health Benefits’ Finance Section analyzes national and state economic trends, changes in the health care market, and trends in Medicaid spending using proven budget and finance practices to prepare the Department and North Carolina for financial challenges that lie ahead. The Provider Audit section examines annual NC Medicaid cost reports submitted by a variety of providers, including hospitals, long-term care facilities, federally qualified health centers, rural health clinics, local health departments, local education agencies, ambulance services, and state-owned and -operated institutions. This team also manages the issuance of cost settlements and hospital supplemental payments.

The primary purpose of this position is to serve as an auditor, to plan and conduct desk review, settlement, data analysis, and reconciliation activities on annual Medicaid and NC Health Choice cost reports including, but not limited to, Rural Health Clinics (RHCs), Federally Qualified Health Centers (FQHCs), and Children's Developmental Service Agencies (CDSAs). This position will verify both accuracy of cost report data and/or ensure compliance with federal and state regulations, N.C. State Plan, Provider Participation Agreements, and the Medicaid Managed Care 1115 Waiver and Contracts.

Job Specific Responsibilities:

• Perform desk review activities on annually filed Medicaid and NC Health Choice cost reports for various provider types including, but not limited to those listed above.
• Generate audit adjustments and recommendations pursuant to these reviews and in accordance with federal and state regulations as well as Generally Accepted Accounting Principles (GAAP) and Generally Accepted Auditing Standards (GAAS).
• Perform accurate data analysis, reconciliations, and cost report settlements on Medicaid and NC Health Choice cost reports in accordance with the NC State Plan and Medicaid Managed Care 1115 Waiver and Contracts.
• Under guidance from Audit Manager, calculate and execute quarterly "wrap-around" payments for FQHC and RHC providers.
• Work to resolve assigned cost report appeals and prepare packages to defend adjustments through the various levels of appeals.
• Respond to technical questions from providers, internal and external staff, and auditors related to assigned cost report and data analysis activities.
• Recommend to management as appropriate when audit findings warrant changes to the State Plan or policy.
• Determine if audit findings warrant referral to Office of Compliance and Program Integrity.
• Perform other duties as identified/required by Finance Section leadership/management.

To receive credit for all your work history and credentials, you must list the information on the application form. Any information listed under the text resume section or on an attachment will not be considered for qualifying credit. Qualified applicants must document on the application that they possess all of the following:

• Proven ability in establishing and maintaining effective working relationships with internal and external stakeholders.
• Working knowledge of Generally Accepted Accounting Principles (GAAP) and Generally Accepted Auditing Standards (GAAS).
• Proven ability to perform accurate analysis and reconciliation of moderately complex cost report data.
• Demonstrated initiative and proven ability to act independently and exercise judgment to produce results, frequently under time constraints.
• Ability to identify substantive issues that are thoroughly and accurately researched and analyzed.
• Ability to understand, interpret, and apply complex State and Federal regulations regarding reimbursement and cost reporting.
• Ability to understand and evaluate cost reporting, cost allocation, and sampling techniques and methodology.
• Ability to communicate professionally in oral and written form including confrontational situations with providers and/or vendors.
• Ability to educate relevant parties regarding programs, procedures and/or eligibility criteria.
• Demonstrated ability using Microsoft Excel and Word.

Management Preferences:

• Previous and proven work experience at Division of Health Benefits/NC Medicaid.
• Familiarity with relevant and current NC Medicaid operations.
• Knowledge of Medicare and/or Medicaid cost reporting forms and Medicaid/Medicare programs and cost reimbursement principles.
• At least 1 year of audit experience in public accounting.
• Certification/licensure as a certified public accountant, certified internal auditor, certified fraud examiner or related certification or licensure.