Financial Analyst

Texas Children's Hospital•Houston, TX

About The Position

We are searching for a Financial Analyst — someone who works well in a fast-paced setting. In this position, you will assist the Chief Financial Officer and Finance Manager in maintaining a framework in which the Health Plan's financial and statistical performance can be continuously measured against quantifiable targets that are established by and acceptable to the various levels of authority, including Health Plan management and the Board.

Requirements

Required bachelor's degree Business Administration, Accounting and/or Finance
Required 1 year Financial or accounting experience
A master's degree in finance, Accounting or Business Administration or a Certified Public Accountant (CPA) license may substitute for the one (1) year of required experience

Responsibilities

Maintains an audit recovery plan for TCHP’s contracts to monitor revenue and expenses that affect the bottom line. Each task is performed monthly.
Compares the capitation membership against the claims data to check for any discrepancies in which TCHP is not receiving capitation dollars from their members or is paying claims for members that are not their responsibility.
Checks the membership aid categories to ensure that TCHP is not carrying a member not included in their contract and provides communication to provider services.
Notifies TCHP’s medical management department of non-delegated claims on members that incur high dollar claims so that they can check to see if their services were authorized correctly, and they are being well managed.
Handles the recoupment of identified receivables due TCHP resulting from claims and capitation audits. Validates capitation dollars paid against the capitation file detail that is sent as backup. Monitors retroactivity on members that are added or termed on capitation.
Responsible for performing various functions related to monitoring the financial performance of TCHP.
Handles all aspects of Reinsurance so that recoupments on high dollar members are received.
Responsible for formatting and translating all electronic data into usable formats sent from each TCHP’s contracts.
Assists in the preparation of monthly, quarterly, and annual financial reports for internal and statutory purposes.
Participates and contributes to routine projects or assignments due to certain items going on at TCHP.
Improves productivity within TCHP by further developing processes to manage data in the most accurate and efficient manner.
Works closely with fellow employees and management at TCHP and contractual contacts to stay on top of issues arising from daily activity.