Financial Analyst

UnitedHealth Group•Ontario, CA

1d•$60,200 - $107,400•Remote

About The Position

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. You’ll enjoy the flexibility to telecommute from anywhere within the U.S. as you take on some tough challenges. Location: 100%25 fully remote. (Travel is 5%25 if in southern California). Overview : A multi-payor healthcare organization contracting with 15 health plans across the Southern California market. The organization generates over $2.5 billion in annual revenue and manages a monthly membership of more than 500,000 lives. Primary market focus includes the Inland Empire and San Diego regions, with close collaboration wand engagement across Los Angeles and Orange County markets. HMO business consists of commercial, point of service, Covered California (ACA) and is analyzed at the plan level. Medi-Cal is broken into categories such as TANF, SPD, Dual, LIC, LTC and separated by Los Angeles, San Bernardino/Riverside, and Orange counties. Medicare business consists of understanding CMS bids, rebates, HCC, RAF scores, risk types, revenue definitions (Parts A & B), and payment integrity. Contracts with health plans such as Aetna, Anthem Blue Cross, Alignment, Blue Shield, IEHP, HealthNet, Humana, SCAN, UHC, Molina, Alignment, Central, Sharp, Scripps, and AHMC. The Inland Empire and San Diego market is broken up into three LCDOs, EPIC, NAMM, and San Diego. Team goals include developing and strengthening existing talent, driving system integration, and leading migration to CapRev to enable real-time data visibility across key partner teams such as Accounting, Payor Contracting, and FP&A. The team is focused on delivering accurate, comprehensive reporting while leveraging large, complex datasets and maintaining a strong understanding of granular data details. Position Details: Must be team oriented and able to manage time effectively. Should be an expert with Excel and must know SQL. Ability to analyze complex data from multiple health plans in a timely manner relating to capitation revenue, CMS ARC codes, payment methodologies, and various plan codes. Submit month end data loads to Accounting by WD -6. This includes data analysis by health plan and products assigned, reconciliation of data relating to membership, revenue, and PMPM, remittances, cash, SOX documentation regarding highlights for MoM analysis. Work through ad hoc requests and submit reports accurately and on time. Communicate effectively both verbally and written, present in meetings while working remotely from home. Potential challenges include migration to CapRev and working with multiple different teams. Candidate Profile: Looking for a self-motivated individual with a curious mindset – someone who is eager to learn, ask questions, and continuously grow. The ideal candidate is driven to make meaningful impact, takes initiative, and thrives in an environment where innovation and improvement are encouraged. Has experience in healthcare administration, including managing and analyzing capitation revenue, with a strong understanding of value-based care models and financial performance. Must maintain a positive attitude and demonstrate flexibility to adapt as business needs evolve. Ability to show expert excel skills and able to write basic queries in SQL. Must be able to meet month end Accounting deadlines and can effectively communicate highlights clearly and concisely in an open forum. You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Requirements

Must be team oriented and able to manage time effectively.
Expert with Excel.
Must know SQL.
Ability to analyze complex data from multiple health plans in a timely manner relating to capitation revenue, CMS ARC codes, payment methodologies, and various plan codes.
Must be able to meet month end Accounting deadlines.
Bachelor’s degree OR certification in Accounting, Finance or IT related field
5+ years of healthcare experience
Advanced level of proficiency in Microsoft (Outlook, Word, Excel, PowerPoint)
Ability to show expert excel skills and able to write basic queries in SQL.

Nice To Haves

Strong analytical skills
Master’s degree or certification in Accounting, Finance or IT related field
Master of Business Administration (MBA)
SQL
Experience with large data sets

Responsibilities

Analyze complex data from multiple health plans in a timely manner relating to capitation revenue, CMS ARC codes, payment methodologies, and various plan codes.
Submit month end data loads to Accounting by WD -6. This includes data analysis by health plan and products assigned, reconciliation of data relating to membership, revenue, and PMPM, remittances, cash, SOX documentation regarding highlights for MoM analysis.
Work through ad hoc requests and submit reports accurately and on time.
Communicate effectively both verbally and written, present in meetings while working remotely from home.