Reporting Financial Analyst III

Job Summary

The Reporting Financial Analyst III is responsible for management and preparation of all month-end financial activity reports. This position reviews and provides detailed explanation of variance report to support trend analysis on Revenue, Capitation, Shared Risk, Pharmacy and claims. This position provides ad hoc analysis to support operational requests as they relate to the product lines and/or implemented pilots, contracts with Participating Physician Groups (PPGs), hospitals and ancillary providers. This position works with Financial Compliance on rate setting, PPG audits and Internal/External audits. This position works very close with other departments to coordinate reporting requests and ensure a complete understanding of variances are documented. This position works with the Revenue unit to validate the Medicare HCC scores. Acts as a Subject Matter Expert, serves as a resource and mentor for other staff.

Duties

Develops and maintains assigned databases, reports, reconciliations in Excel, Access and SQL SSRS and SSIS for internal and external consumption.

Assists management with reports, reconciliations, and monthly closings.

Provides ad hoc analysis to support operational requests as they relate to the L.A. Care's LOBs, claims, contracts with Participating Physician Groups (PPGs), hospitals and ancillary providers.

Audits and validates data for conversion and import.

Prepares monthly Department of Health Care Services (DHCS) submissions and assists with all other state or federal submissions and audits.

Develops, interprets, and implements financial concepts for financial reporting and control.

Applies subject expertise in evaluating business operations and processes. Identifies areas where technical solutions would improve business performance. Consults across business operations, providing mentorship, and contributing specialized knowledge. Ensures that the facts and details are correct so that the project’s/program's deliverable meets the needs of the department, organization and legislation's policies, standards, and best practices. Provides training, recommends process improvements, and mentors junior level staff, department interns, etc. as needed.

Perform other duties as assigned.

Duties Continued

Education Required

Education Preferred

Experience

Required:
At least 5 years of finance or managed healthcare experience with the demonstrated experience on the following list of stated  knowledge, experience and/ or skills.

Preferred:  
Experience with MHC, Trizetto, BI360.

Skills

Required:

Strong accounting, analytical, and problem-solving skills.

Excellent oral and written communication skills.

Excellent data management/ database skills.

Must have advanced PC Skills (Excel, Word, Access) ASP, and SQL or Monarch.

Must be familiar with claim CPT/ICD 10 codes.

Strong Health Care industry knowledge.

Preferred:
Medi-Cal and Medicare knowledge.

QNXT application knowledge.

Licenses/Certifications Required

Licenses/Certifications Preferred

Required Training

Physical Requirements

Additional Information