Healthcare Analyst III

Medica•Minnetonka, MN

7h•$90,500 - $155,200•Hybrid

About The Position

The Healthcare Financial Data Analyst supports the preparation, validation, and submission of financial and operational data required by state Medicaid agencies and other regulatory stakeholders. This role works with financial, claims, enrollment, provider, and other healthcare data to ensure submissions are accurate, complete, consistent, and delivered in accordance with established reporting requirements and timelines. The analyst will collaborate with Finance, Actuarial, Accounting, Medicaid Operations, Data/IT, and other business partners to understand reporting requirements, reconcile data across systems, investigate variances, and develop repeatable processes for regulatory reporting. Prior Medicaid reporting experience is beneficial but not required. Successful candidates will bring strong analytical and problem-solving skills, experience working with complex financial or healthcare data, and the ability to learn new reporting requirements and business processes.

Requirements

Bachelor's degree in Finance, Accounting, Economics, Actuarial Science, Business Analytics, Data Analytics, Mathematics, Healthcare Administration, or a related quantitative field.
5 years of professional experience in financial analysis, healthcare analytics, data analysis, accounting, regulatory reporting, or a related analytical role.
Demonstrated ability to work with large and complex datasets and reconcile information across multiple data sources.
Strong analytical and problem-solving skills, including the ability to identify unusual results, investigate discrepancies, and communicate findings.
Proficiency with Microsoft Excel, including experience using formulas, pivot tables, lookups, and other tools for analyzing and reconciling data.
Ability to interpret detailed reporting instructions and translate requirements into analytical processes.
Strong attention to detail and commitment to data accuracy.
Ability to organize and document analytical processes so they can be understood, reviewed, and repeated by others.
Strong written and verbal communication skills and the ability to work effectively with both technical and nontechnical stakeholders.

Nice To Haves

Experience working with healthcare claims, enrollment, provider, financial, or utilization data.
Experience with SQL, relational databases, data warehouses, or business intelligence tools.
Experience preparing regulatory, governmental, statutory, or other externally submitted financial reports.
Familiarity with Medicaid managed care, Medicare, commercial health insurance, or other healthcare payer operations.
Experience working with financial reconciliations, general ledger data, capitation payments, medical claims expense, pharmacy expense, or healthcare revenue.
Experience developing automated or semi-automated reporting and data validation processes.

Responsibilities

Support the preparation and submission of Medicaid financial, encounter, enrollment, and related regulatory data to state agencies in accordance with established requirements and deadlines.
Extract, compile, analyze, and validate data from multiple financial and operational systems to support recurring and ad hoc state reporting.
Perform data reconciliations, reasonability checks, and variance analyses to identify potential data quality or reporting issues prior to submission.
Research discrepancies and collaborate with Finance, Actuarial, Accounting, Medicaid Operations, IT/Data, and other subject matter experts to resolve issues.
Develop a strong understanding of the source-to-submission data flow, including data definitions, calculation methodologies, business rules, and reporting requirements.
Maintain clear documentation of reporting processes, data sources, assumptions, business rules, validation procedures, and issue resolutions.
Assist with interpreting state reporting instructions and translating requirements into repeatable analytical and reporting processes.
Respond to questions and data inquiries related to previously submitted information, including researching historical results and providing supporting documentation.
Identify opportunities to improve, standardize, and automate reporting and validation processes, reducing manual effort and improving data accuracy.
Support internal and external audits, regulatory reviews, and other requests by providing data, reconciliations, documentation, and analytical support.
Develop working knowledge of Medicaid financing, managed care reporting requirements, and healthcare financial concepts relevant to assigned reporting responsibilities.
Manage multiple recurring reporting deliverables while maintaining appropriate controls and meeting established deadlines.