To support the financial reporting and analytical processes by analyzing actual performance against budget for profit and loss information and other data in order to identify, evaluate, and communicate drivers of performance. Develops, coordinates, and is directly involved in projects and activities that help drive business decisions, affect provider reimbursement programs such as P4P, and provider capitation configuration. Works collaboratively with staff in Finance/Accounting in the ongoing analysis and reporting of all aspects of the income statement and other operating metrics.
- Develops, interprets and implements financial models and concepts for financial planning and analysis.
- Uses, maintains, and updates the financial analysis and reporting models to ensure the accuracy, validity, and reliability of the model and the data.
- Adapts the financial analysis and reporting models to meet the growing and changing needs of the HealthPlan and to reflect changes in the regulatory environment.
- Assist with review and presentation of IBNR analysis and reports.
- Designs and implements improvements in executive level financial presentations, including dashboards for executive leadership, Finance Committee and Board of Directors presentations.
- Supports management in making data driven decisions by providing clear and accurate financial summaries.
- Collaborates with management and cross-function teams to understand strategic initiatives’ budget impact.
- Analyzes performance vs. multi-year budgets and projections, and provides management with insights on trends, financial summaries and ways to optimize performance. Effectively track results and explain variances.
- Produces and analyzes the financial performance for various provider contracts including incentive programs, as well as other financial terms of contracts.
- Designs and generates decision support tools that focus on membership, utilization, trends, State capitation rates and provider contracting. Based on detailed analytics, creates actionable information that results in identifying trend drivers and opportunities for improvement.
- Prepares and presents data interpretation and recommendations at a level understood by diverse audiences including staff, all levels of management, physicians, board of directors, and external customers
- Works on complex problems and provides solutions that are innovative and sophisticated to achieve high quality work process improvements.
- Uses established methods, techniques, and tools to document and maintain all deliverables created in accordance with department policies; assists in the identification of criteria and effective measurement tools.
- Coordinates with other departments in collecting raw data and publishing reports for both internal and external needs.
- Works collaboratively with IT to enhance automation of processes and to identify new tools to facilitate standard querying and reporting; ensure accuracy of downloaded databases.
- Participates in special projects and assignments as needed.
- Other duties as assigned.
Education and Experience
Bachelor’s degree in Finance, Accounting, Economics or related field; minimum five (5) years’ progressive experience in healthcare FP&A; experience leading and directing detailed data analysis projects; or an equivalent combination of education and experience.
Special Skills, Licenses and Certifications
Strong working knowledge of managed care financial principles, experience with MediCal managed care desired. Detailed knowledge of healthcare industry reporting requirements, terminology and policies. Strong data management, audit control, version management, and reconciliation management skills required. Ability to conduct statistical analysis and techniques. Strong working knowledge and experience with Microsoft Office products, relational databases, and other analytical tools such as SAS. SQL programming a plus. Proficient in Tableau or other data visualization programs.
Performance Based Competencies
Must demonstrate strong verbal and written communication skills, as well as strong presentation skills: ability to clearly communicate complex information to diverse audiences. Ability to communicate data needs to various customers (internal and external) in order to compile and produce necessary reports. Excellent analytical, problem solving, investigative and research ability. Ability to work in a team environment, take and give direction, follow through with tasks and projects, compromise, negotiate and achieve consensus decisions, support consensus decisions, be flexible and adaptable to changes in assignments and the work environment, work independently, manage time efficiently and multi-task effectively. Ability to determine appropriate courses of action in complex situations that may not be addressed by existing policies or procedures. Ability to make decisions that require significant analysis and investigation with solutions requiring original thinking.
Work Environment And Physical Demands
Ability to use a computer keyboard and 10-key calculator. More than 70% of work time in front of a computer monitor. When required, ability to move, carry, or lift objects of varying size, weighing up to 10 lbs.
All HealthPlan employees are expected to:
- Provide the highest possible level of service to clients;
- Promote teamwork and cooperative effort among employees;
- Maintain safe practices; and
- Abide by the HealthPlan’s policies and procedures, as they may from time to time be updated.
IMPORTANT DISCLAIMER NOTICE
The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this job description are representative only and not exhaustive or definitive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.