The Managed Care Finance team administers the financial terms and conditions of our capitated contracts with IPA/ Medical Groups, Hospitals, and Vendors. The Financial Analyst, Experienced will report to the Manager of Managed Care Finance. In this role you will be performing provider contract analysis, financial research, preparing financial forecasts, analyzing data trends, and translating data into useful information. You will interact with a variety of internal units as well as IPA/ Medical ... more details
Your Role
The Managed Care Finance team administers the financial terms and conditions of our capitated contracts with IPA/Medical Groups, Hospitals, and Vendors. The Financial Analyst, Experienced will report to the Manager of Managed Care Finance. In this role you will be performing provider contract analysis, financial research, preparing financial forecasts, analyzing data trends, and translating data into useful information. You will interact with a variety of internal units as well as IPA/Medical Groups to monitor financial payments and reporting to ensure compliance with contractual requirements and governmental regulations.
Your Work
In this role, you will:
Analyze limited raw revenue/expense data and summarize detailed revenue/expense data; compare summarized claim data against fee schedules and contracts
Assist with production of contract performance reports, modeling of reimbursement rates, evaluation of financial contract modifications and compiling and monitoring key managed care statistics
Participate in the development of financial models; collect and evaluate data, analyze results
Follow and conduct audit processes and review internal controls to ensure financial transactions are accurate, timely and comply with accounting standards, principles and company policy
Generate reporting and provide analysis of capitation, eligibility, membership, shared risk arrangements, claims, and provider incentive programs
Develop financial accruals and prepare payments for expenses related to retroactive capitation rate increases, shared risk settlements, provider incentives, provider claims, and other non-standard contract provisions
Provide contract interpretation consultation (including non-standard contracts) to internal business units and external provider customers
Assist in the development of new processes and reporting mechanisms to meet company needs and improve customer service
Address and/or resolve non-standard customer issues and builds strong relationships with customers
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