Jobs

Description

This request is for a short term project - about 8-12 week assignment. This is a 40 hour/week role.

Job Summary:

• The Managed Care Analyst advances Client's Managed Care Contracting and Operational strategies through financial analysis, contract modeling, and advisory support.
• This role reports to the Manager of Managed Care Analytics and sits at the system level supporting all MHS entities: Hospitals, Foundation, IPA and Health Plan.

Job Responsibilities:

• The position supports the Managed Care strategy by assembling and analyzing financial data for routine reports.
• Sources include but are not limited to: Snowflake, payor capitation data, cost accounting system data, GL, budgeting and patient billing data.
• Evaluate complex commercial and government payer arrangements including ACOs, Direct to Employer, Medicare Advantage, Medi-Cal, medical group, and ambulatory contracts.
• Provide financial analysis and ad hoc reporting to internal stakeholders and leaders.
• Collaborate with senior team members and cross-functional departments to design and run queries and reports based on external reporting requests, ensuring data integrity, actuaries and timeliness.
• Model specific reimbursement terms to support the Managed Care negotiation team, including MCMF, MHS, and MCSHP.
• Develop and maintain reporting templates to measure performance of health plan trend and yield to proactively report out on a monthly basis, depending on reporting area(s) assigned.
• Support monthly financial close by proactively identifying trends, outliers, requested reports and answering inquiries, depending on reporting area(s) assigned.
• Complete and distribute monthly reporting packages to internal stakeholders, depending on reporting area(s) assigned.
• Prepare performance and contracted rates modeling reports for health plan contract negotiations.
• Populate pre-defined templates with health plan data for analysis by senior team members, ensuring data integrity, identifying potential anomalies and collaborating with senior team members regarding appropriate follow up.
• Promptly respond to financial statement audit requests, addressing inquiries quickly, completely and accurately with some direction from supervisor.
• Prepare monthly hospital reporting packages accurately and include some analysis of fluctuations.
• Collaborate with senior team members and other departments to design and run queries to identify trends and patterns.
• Complete analysis of medical expense fluctuations thoroughly, accurately and within established deadlines with some direction from supervisor.
• Organize report recipient questions and work with senior analysts or management to assist managers in understanding their financial data.
• Complete ad hoc reports/requests accurately, timely and in line with established expectations with some direction from supervisor.
• Work with external vendors to problem-solve issues identified.
• Demonstrate accountability by identifying, analyzing, and resolving complex financial and operational issues, delivering accurate and actionable insights that support organizational decision-making.

Required Skills & Experience:

• Two (2) years experience, preferably in Managed Care analytic setting.
• Proficient in SQL development and Epic systems, with advanced Excel capabilities, alongside strong command of Microsoft Office tools.
• Extremely organized with strong sense of priority, urgency and commitment to deadlines.
• Self-motivated individual able to handle fluctuating volumes of work, able to prioritize to meet deadlines.
• The Analyst will attain competency with: (1) Snowflake (2) SQL (3) Accounting systems (4) EPIC to analyze data and trends.

Required Education:

• Bachelor's degree in Business, Finance or Healthcare.