Cost and Utilization Analyst (PCN 1361)

Oakland Community Health Network•Troy, MI

69d•$56,165 - $70,206•Hybrid

About The Position

The Cost and Utilization Analyst (CUA) is responsible for analyzing and reporting on service delivery and billing activity across multiple provider networks. Analysts’ work informs budget preparation, contract compliance, rate setting and provider relations. The CUA partners with internal program and fiscal and external provider stakeholders to assess and properly classify and quantify service delivery and financial results tied to people served.

Requirements

Bachelor’s degree in Business Administration, Finance, Accounting, or Related discipline.
Experience in accounting, finance, or related field.
Experience with both preparing and leading data analytics projects required.
Understanding of generally accepted accounting principles, including accrual based accounting and standard cost allocation.
Minimum 3-5 years of experience with both preparing and leading data analytics projects required.
Highly developed computer skills.
Highly proficient Excel spreadsheet skills
Excellent communication skills including written, verbal, and presentations
Highly effective interpersonal skills in working with Provider Networks.
Ability to prepare and analyze complex budgets.
Ability to review and analyze cost allocation.
Ability to work with and analyze financial information of a complex nature.

Nice To Haves

Knowledge of Medicaid rules and regulations and financial experience in the field of healthcare.

Responsibilities

Collect, analyze, and interpret data and statistics tied to cost and utilization trends in services using quantitative and qualitative methods to monitor budget and reporting compliance.
Assists with preparation of Encounter, Medicaid Loss Ratio and Financial Status Reports to Michigan Department of Health and Human Services (MDHHS) through the year
Serve as primary financial liaison regarding financial issues and coordinate the financial activities policies, procedures, and directives between the contract providers and OCHN
Represent OCHN on financial workgroups and periodic meetings for their respective provider network(s)
Act as a liaison between the provider network and MDHHS to communicate feedback regarding changes to funding, procedure codes, and reporting requirements
Prepare and present complex and detailed statistical analyses and graphical representations of data findings for inclusion in internal and external reports
Provide statistics and established benchmarks regarding cost and utilization statistics.
Understand fund source allocation for revenue and expense reporting and compile, analyze and report on operational information including trends, staffing/resource allocation, and budgeting
Other duties as assigned