Apply

Financial Analyst

Job Overview
Job Order:JO00020130
Date Posted:Mar 10
Salary:$40.00/Hour
Category:1 - Accounting & Finance
Metro Area:

Our Health Systems client in Troy, MI needs to hire a Financial Analyst to provide support in the area of Risk Adjustments for the Medicare program.

JOB TYPE: Full time. 3-month contract, possible to extend or convert based on performance and business needs.

PAY: $38.00 to $42.00 per hour

SCOPE: Assist the Finance Reporting and Analysis Division working in multiple systems to provide / analyze data to make decisions on risk adjustments for the Medicare program. Ensure the correct reporting of revenue to the government for assigned areas.

DUTIES

  • Compile CMS premium payment and revenue reconciliation reports for monthly financial close process; file payment issues with CMS and monitor response; monitor MMR accruals; estimate risk adjustment premium impact for midyear and final reconciliation with CMS; allocation of premium to at-risk provider networks.
  • Primary user of Risk Adjustment software. Monitor system for assessment of RAPS and EDPS data submission / acceptance status, progress of risk projects, utilization of Vendor supplemental data to assist in risk adjustment project pricing.
  • SME Liaison to multiple departments within the organization, for expertise in government programs, payment methods, revenue attribution, and risk adjustment.
  • Maintenance of the following queries and analysis: Reconciliation reports for CMS MA Part C/D Risk Adjustment program receivables and payables for monthly accounting needs. Monitor accruals for final reconciliation with CMS.
  • Maintenance of the following queries and analysis: Reconciliation reports for CMS Part D Reinsurance, Low Income Cost Sharing, Risk Sharing program receivables and payables for monthly accounting needs. Monitor accruals for final reconciliation with CMS.
  • Develop and enhance reporting capabilities for financial and operational performance.
  • Support annual financial reporting activities.

EDUCATION AND EXPERIENCE:

  • Bachelor Degree in Accounting, Finance, Statistics, Data Analytics, Health Care Services or Business Admin required.
  • Finance experience in Health Care Insurance or Managed Care Organization. Experience with Medicare Advantage, Medicare Part D, Medicaid or Qualified Health Plans or Affordable Care Act required.
  • Strong understanding of Risk Score, CMS Risk Adjustment HCC and RxHCC models, RAPS/EDPS data, and impact on premiums in government programs.
  • Accounting and finance principles as they relate to revenue payments, claims, and membership data, financial projections, variance analysis. Understanding of heath care finance, claims processing, Medicare and Medicare/Medicaid program payment methods.
  • Software experience: CMS Payment System, Advanced Excel, Advanced Access required. Oracle Financials, Power BI and/or Tableau experience highly desired.

If you are a high performer and would like to work for an equally high performing company and you think the above opportunity is appropriate for you, we invite you to apply to this job and email your resume to OPerryman@venteon.us.com

We treat all resumes with strict confidentiality. We will always contact you first before submitting your resume to our client(s) for review. If you do not receive correspondence, you are not a fit for this position.

At Venteon, our talent acquisition team is proud to provide our clients with the most qualified Accounting & Finance, Engineering and IT talent in the industry today.

#VTN2