Financial Analyst

High Desert Pace Inc•Victorville, CA

About The Position

Reporting to the Director of Quality and Compliance, The Finance Analyst is a key member of the finance team responsible for the accurate recording, reconciliation, and reporting of all revenue and expense activity in support of High Desert PACE’s capitated payment model. This role ensures timely and compliant financial entries, manages critical healthcare-specific accruals and estimates (including IBNR), supports regulatory submissions to CMS and DHCS, assists with the annual Part D bid process and program oversight, and collaborates across departments to maintain strong financial controls and budgeting processes.

Requirements

Work independently and as an effective member of a team.
Establish and maintain effective interpersonal relationships with all levels of staff, other programs, agencies, members, providers and the public.
Communicate effectively, both verbally and in writing, with individuals from varying cultural backgrounds.
Prepare concise and clear reports.
Effectively utilize computer and appropriate software and interact as needed with High Desert PACE Information Systems.
Foster and model an effective team environment, where each team member is held accountable for their independent work.
Approach leadership with an openness to new ideas, cultural humility and acknowledgment of the dynamics of privilege.
Techniques of financial forecasting & planning, quality, and research methods.
Principles and practices of health care, health care systems, and managed care
Medicare and Medi-Cal benefits and regulations
Community-based organizations, agencies, and community services
Team and value-based care
Regulatory policies, rules, and regulations
Bachelor’s degree in finance or business (or related degree)
Minimum two years’ experience working in the finance of healthcare services or insurance products.

Responsibilities

Enter Medicare and Medi-Cal accrual entries into accounting system to properly recognize capitated revenue and related expenses in accordance with CMS and DHCS guidelines.
Prepare the Incurred but Not Received (IBNR) file for the actuary, submit it timely, and enter the final IBNR journal entry received from the actuary into accounting system to accurately reflect medical claims liabilities.
Prepare and enter bi-weekly payroll journal entries using data extracted from payroll system.
Complete DHCS Monthly Financial Preparation and DHCS Quarterly Financial Preparation, including all required schedules and supporting documentation.
Attend actuarial webinars and related training in preparation for the Annual Part D Bid Process.
Review monthly PDE (Prescription Drug Event) return files, identify and correct rejections, and ensure accurate and complete submissions to CMS.
Prepare and enter the monthly company credit card journal entry.
Resolve finance-related customer service issues for participants, providers, and internal stakeholders.
Perform Medicare/Medi-Cal Payment Review & AR Management, including follow-up on outstanding receivables.
Conduct RAPS/EDS File Review to support accurate Medicare risk-adjustment data and payment integrity.
Review monthly files from the PBM and reconcile pharmacy benefit costs.
Work directly with DHCS on outstanding AR to facilitate timely resolution and collections.
Prepare annual budget files and collaborate with department directors to develop, review, and finalize departmental budgets.
Participating in staff meetings, trainings, assigned projects, and committees
Complying with all organizational policies, procedures, and scheduling requirements
Performing all other duties as assigned in a cooperative and flexible manner
Being available for flexible scheduling, including varying hours as needed
Utilizing a personal vehicle when required for work-related tasks