Senior Revenue Analyst

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 interpret financial and enrollment data, identify opportunities and problems, and develop financial models to assess the impact of regulatory changes and market dynamics. A key aspect of the role is performing variance analysis, collaborating with various teams for accurate revenue recognition, and ensuring compliance with policies and regulations. The position also includes recommending process enhancements, mentoring junior analysts, and potentially leading projects.

Requirements

Bachelor's degree and five (5) years of related experience; or an equivalent combination of education and related work experience.
Strong presentation skills to peers, management and executive staff.
Working knowledge of Medicare Advantage, Medicaid, and/or ACA revenue cycles for payers.
Strong working knowledge of claims, health plan financial data, and health industry structure.
Advanced 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 with minimal guidance.
Interpret financial and enrollment data from internal and external sources, identifying opportunities and problems compared to anticipated outcomes.
Evaluate financial data needs and identify and implement solutions for programs driving accurate coding and documentation to optimize revenue.
Develop 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, providing actionable insights to leadership.
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, and recommend strategic alternatives.
Develop, maintain, and analyze appropriate documentation of desktop procedures for reconciliation and audit needs.
Build and maintain in-depth knowledge of revenue structures and regulations and conceptual knowledge of related activities.
Recommend and implement process enhancements to improve the accuracy and efficiency of revenue analysis.
Mentor junior analysts and may be assigned project lead requiring some resource planning assignments.
Perform all other miscellaneous responsibilities and duties as assigned or directed.