Senior Analyst, Managed Care Patient Finance
About The Position
The Managed Care Patient Financial Senior Analyst analyzes financial and health information to develop insights that support business decisions related to healthcare revenue, costs, and clinical outcomes, with a focus on the managed care industry. The position prepares and completes managed care reporting, including auditing capitation revenue; reviewing PCP and specialty capitation; preparing risk pool and incentive summaries; assisting with risk pool audits and analysis; and identifying revenue-capture opportunities such as health-plan capitation underpayments, specialty claims overpayments, leakage claims, and billable services. The analyst also participates in annual budgeting and prepares recurring or as-needed financial analysis and other reporting relevant to healthcare, utilization, and financial management for AltaMed IPA. The position requires a bachelor's degree in accounting, finance, business, or a related area and at least five years of relevant experience, or a related master's degree and at least three years of relevant experience. Experience with databases and data analysis technology is required, and Microsoft Access is a must. EZ Cap and SQL experience are highly desirable.
Requirements
- Bachelor's degree in accounting, finance, business, or a related area and a minimum of five years of experience in financial analysis and database reporting in the healthcare or managed care industry; alternatively, a master's degree in a related field and three years of relevant experience.
- Experience with databases and data analysis technology.
- Microsoft Access proficiency.
Nice To Haves
- EZ Cap experience.
- SQL experience.
Responsibilities
- Analyze financial and health information to support business decisions related to healthcare revenue, costs, and clinical outcomes.
- Prepare and complete managed care reporting.
- Audit capitation revenue and review PCP and specialty capitation.
- Prepare risk pool and incentive summaries.
- Assist with risk pool auditing and analysis.
- Identify revenue-capture opportunities, including health-plan capitation underpayments, specialty claims overpayments, leakage claims, and billable services.
- Participate in annual budgeting.
- Compile recurring and as-needed financial analysis and reporting relevant to healthcare, utilization, and financial management for AltaMed IPA.
Benefits
- Medical, dental, and vision insurance.
- 403(b) retirement savings plans with employer matching contributions.
- Flexible Spending Accounts.
- Commuter Flexible Spending.
- Career advancement and development opportunities.
- Paid Time Off and holidays.
- Paid CME days.
- Malpractice insurance and tail coverage.
- Tuition reimbursement program.
- Corporate employee discounts.
- Employee referral bonus program.
- Pet care insurance.
- The role may qualify for discretionary bonuses or incentives.
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What This Job Offers
Job Type
Full-time
Career Level
Senior
