Revenue Analyst II

HMSA•Honolulu, HI

3d•Hybrid

About The Position

This role involves analyzing and forecasting premium revenue, risk adjustment payments, and other revenue streams. The analyst will gather, validate, and interpret financial and enrollment data, support RAF and financial data needs for accurate coding and documentation, and run financial models to assess the impact of various factors on revenue. Key responsibilities include variance analysis, ensuring accurate revenue recognition and reporting, and adhering to internal policies and regulatory guidelines. The position also requires developing and maintaining documentation for reconciliation and audit purposes, maintaining knowledge of revenue structures and regulations, identifying process improvements, and providing informal guidance to new team members.

Requirements

Bachelor's degree and four years of related experience; or an equivalent combination of education and related work experience.
Strong oral and written communication skills for presenting complex information.
Working knowledge of the techniques used to present financial or statistical data.
Working knowledge of claims, health plan financial data, and health industry structure.
Intermediate working knowledge of Microsoft Office applications, including but not limited to Word, Excel, Outlook, and PowerPoint.

Responsibilities

Analyze and forecast premium revenue, risk adjustment payments, and other revenue streams related to lines of business using prescribed guidelines or policies.
Gather, validate, and interpret financial and enrollment data from internal and external sources.
Support RAF and financial data needs of program driving accurate coding and documentation to optimize revenue from evaluation and interpretation of the information.
Run and maintain financial models to assess the impact of regulatory changes, enrollment trends, and market dynamics on revenue.
Perform variance analysis to identify and explain variances between actual and projected revenue.
Collaborate with actuarial, finance, compliance and operations teams to ensure accurate revenue recognition and reporting.
Ensure all revenue analysis and reporting adhere to internal policies and regulatory guidelines.
Develop and maintain appropriate documentation of desktop procedures for reconciliation and audit needs.
Maintain working level knowledge of revenue structures and regulations.
Identify gaps and assist in implementing process enhancements to improve the accuracy and efficiency of revenue analysis.
Provide informal guidance to new team members.
Perform all other miscellaneous responsibilities and duties as assigned or directed.