Senior Financial Health Care Data Analyst I

HMSA•Honolulu, HI

2d•Hybrid

About The Position

This role involves developing, analyzing, recommending, and monitoring reimbursement and provider strategies. The analyst will prepare reports to measure the effectiveness of reimbursement and contracting terms and their impact on program costs and utilization. Key responsibilities include analyzing data to identify trends and cost reduction opportunities, monitoring market trends, and staying updated on reimbursement and policy changes. The position also requires analyzing financial and operational reports, leading internal controls, defining data requirements, and creating summary reports for management. Data quality and consistency are crucial, involving proactive problem identification and resolution. The role includes annual reviews of compliance workflows like SSAE and MAR, and ensuring provider contracts are accurately reflected in the claims system. Additionally, the analyst will promote team activities through leadership, consultation, and sharing expertise, while also performing other assigned duties.

Requirements

Bachelor's degree and three years of related work experience, or an equivalent combination of education and related work experience.
Demonstrated budgeting, forecasting, and variance analysis skills.
Basic knowledge of Microsoft Office applications. Including but not limited to Word, Outlook, and Power Point.
Intermediate working knowledge of Excel.

Responsibilities

Develop, analyze, recommend, and monitor reimbursement and provider strategies.
Prepare reports that measure the effectiveness of reimbursement and contracting terms and their influence on overall program/plan cost and utilization.
Analyze data and identify trends, patterns, or other notable issues with an eye for cost reduction opportunities.
Monitor market trends to identify emerging opportunities or risks in business environments.
Monitor websites for reimbursement and policy changes for both private and government entities; make recommendations for implementation of these changes.
Analyze standard plan or provider financial and operational reports in response to customer requirements and business needs.
Lead and implement internal controls; Facilitate definition of data and other information requirements; Define efficient data assembly methods; and maintain adequate documentation for general reference and audit purposes.
Create functional summary reports for presentation to management.
Validate and maintain quality and consistency of data and reporting.
On a proactive basis identify and isolate potential problems and work with staff within and outside of the department to develop and implement resolutions; develop and communicate data adjustments and workarounds.
Propose resolutions to management to clearly define the increase in value and productivity associated with the changes.
Annual review of compliance workflows, such as, SSAE, MAR.
Review provider contracts and ensure that claims system set ups accurately reflect fully executed, signed agreements.
Participates and promotes team activities by providing leadership, consultation, managing other projects, sharing accountability and expertise, communicating, and improving integrity of workflows, and providing constructive feedback on other team members' performance.
Perform all other miscellaneous responsibilities and duties as assigned or directed.