Financial Analyst

Our client, a healthcare provider in Bronx, NY, is seeking a Financial Accountant to join their team.

The Financial Analyst of Revenue and Claims ideally will be an analyst with a strong background and three/four-year experience in dealing with health care data, and who is also comfortable building new reporting processes. He/she will be with closely with the Manager of Revenue and Claims, responsible for defining, managing, and refining membership attribution to the primary care physician and MCO contract level. He/she will be responsible for the accurate reporting of all membership-related activity into a statistical ledger, based on documented policies and procedures. The financial analyst reports to Manager of Revenue and Claims. An advanced degree would be considered but is not required.

The financial analyst will work closely with other members of the Finance team, as well as internal Clinical/Quality/Network management, and MCO/TPA partners to ensure that membership is consistently reported and fully incorporate retroactive adjustments as they become known.

Essential Duties:

Assists in designing, implementing and/or refining an eligibility reconciliation process to validate monthly membership, ensuring the most accurate patient assignment and MCO payment possible.
Creates, reviews, analyzes, and communicates reports associated with new enrollments, disenrollments, changes in premium rate cells, changes in MCO contracts, and mid-month membership changes.
Assists Manager of Revenue & Claims, Financial Controller, and CFO in revenue and claims data management including paid claims trends in quarterly/annual budget development and forecast.
Develops and maintains a statistical ledger covering both reported and re-stated membership activity to facilitate "per member per month" financial analyses.
Translates membership data to reflect premiums, and to accrue related receivables and liabilities
Assists in the design and implementation of a monthly process to reconcile differences in reported membership from multiple sources (MCO, Partners, NYS DOH, PCP rosters).
Co-owns with Manager of Revenue and Claims the ETL process for membership data, supplemented by manual exception processes.
Communicates information related to previously unreported receivables and payables tied to retroactive enrollments and disenrollments to the appropriate departments and stakeholders.
Assists in the development of processes to monitor and communicate expiring eligibility status to limit involuntary disenrollments.
Identifies opportunities to expand Innovator membership management functions to provide meaningful streamlined support to other IPAs.
Supports an array of internal financial initiatives, such as the preparation of internal financial statements and audit required materials.

Qualifications:

Three-Six years of experience at the financial analytics level in a managed care government program environment.
Advanced degree considered but not required.
Familiarity with Medicaid and Medicare membership reporting functions
Experience as an end user/business owner of an ETL batch process
Ability to build collaborative relationships with peers and stakeholders within the organization.
Knowledge of governmental and healthcare fiscal regulations and reporting requirements.
Experience in big data management and create pivot tables to communicate data in a meaningful way for various purpose including but not limited to accounting journal entries.
Experience or some exposure to financial budget and modeling.
Outstanding oral and written presentation skills.
Excellent skills in Excel/Pivot table required; Knowledge in VBA/SQL/Tableau strongly preferred

The compensation for this position ranges from $70,000.00 - $90,000.00. Actual compensation will be dependent upon the specific role, office location as well as the individual's qualifications, experience, skills and certifications.