Medicaid Disproportionate Share Hospital (DSH) Payment Analyst

Job Title: Medicaid Disproportionate Share Hospital (DSH) Payment Analyst
Work Arrangement: Remote within the continental United States, with occasional travel to Pierre, SD
Location: Remote; client office in Pierre, SD 57501
Employment Type: Contract, two-year engagement expected to begin June 2027, with possible extension
Engagement Type: C2C, W-2, or 1099
Final Interview: Online interview

Position Summary

Dhaka Technologies Limited Company is hiring a Medicaid Disproportionate Share Hospital (DSH) Payment Analyst on behalf of a client, a state Medicaid agency, to provide technical support and analysis for the state's DSH supplemental payment program. The Analyst assesses federal policy changes and court decisions affecting DSH, evaluates and recommends improvements to the program, collects and validates hospital data, calculates DSH rates and payments under the State Plan methodology, drafts the annual DSH payment schedule, supports DSH audits, and educates participating hospitals on DSH requirements, data sources, and survey tools. The work is performed remotely, with a small portion on site at the client office.

Responsibilities

• Assess recent court decisions and changes or clarifications in federal DSH policy, and advise the state on the potential impact to its Medicaid program and State Plan.
• Assess whether State Plan resubmissions are needed and support their preparation.
• Evaluate the current administration of DSH supplemental payments and recommend improvements, including potential changes to the size and scope of the program.
• Identify the artifacts, information, and documentation needed to calculate DSH payments under federal and state rules.
• Draft proposed communications to eligible hospitals on the methodology, data collection process, and submission deadlines, for state approval before outreach.
• Gather data for the year under review from eligible hospitals, the state, and other sources; review it for reasonableness and accuracy; and resolve discrepancies with hospitals and the state.
• Calculate DSH rates and payments, build the payment model for the year under review, review the draft model with the state, make requested modifications, and deliver final calculations in the format the state specifies.
• Draft the DSH payment schedule for the upcoming state fiscal year.
• Support DSH program audits, including responding to auditor requests and reconciling data.
• Develop and deliver education for DSH-eligible hospitals on DSH requirements, data sources, survey tools, and best practices for documenting DSH eligibility.
• Keep work activities on schedule and in line with proven standards and methodologies.

Required Qualifications

• At least three years of experience working with Medicaid DSH rules, regulations, and related issues, including DSH payment calculations, DSH audits, or hospital DSH survey work.
• At least three years of experience working with Medicaid rules, regulations, and related issues, including State Plan payment methodologies.
• Hands-on experience working with Medicaid data, such as claims, eligibility, or payment data.
• Advanced Excel skills for building and documenting payment models; SQL or SAS for data validation is a plus.
• Ability to explain DSH methodology clearly to hospital finance staff and state program staff, in writing and in training sessions.
• Availability for a two-year engagement beginning about June 2027 and for occasional travel to Pierre, SD.
• Three professional references who can speak to your Medicaid DSH or Medicaid payment work.
• Must currently reside in the continental United States. Visa sponsorship is available for qualified candidates.

Preferred Qualifications

• Experience with a state Medicaid agency, a Medicaid financing or reimbursement consulting firm, or a hospital association on DSH or other supplemental payment programs.
• Experience with hospital cost report data, including Medicare cost report (CMS 2552) data, and with uncompensated care data.
• Experience with federal DSH audit and reporting requirements under 42 CFR 455 Subpart D and with the hospital-specific DSH limit.
• Experience with other Medicaid supplemental payment programs, such as upper payment limit or directed payments.
• CPA, MHA, or a related degree in health administration, accounting, or finance.

Compensation

$25 to $30 per hour on a C2C, W-2, or 1099 basis, based on experience. Travel to the client office is reimbursed at state rates.

How to Apply

Send a current resume to with the subject line "Medicaid DSH Analyst, Remote." Please include two or three sentences describing the DSH payment calculation or audit work you have done and the states or clients it was for, and three professional references (name, title, organization, email, and phone) who can speak to that work.

Originally posted on Himalayas