Senior Financial Health Data Analyst II
hmsaHonolulu (HI)
Senior Financial Health Data Analyst II
Posted 53 days ago
hmsaHonolulu (HI)
SENIORITY
Senior
About the role
Job Description:
- Design, develop and implement 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.
- Interpret data and develop reports to communicate findings to senior management.
- Participate in project workgroups; facilitate definition of project requirements and deliverables; influence the progress of team activities and the successful implementation of the project. Document and share project activities, analyses, and decisions.
- Develop, analyze, recommend, and enhance workflow processes related to project deliverables.
- Evaluates alternative solutions/decision in light of the potential impact on internal/external resources; understand the resource implications of solutions and makes other recommendations; communicate status and recommendations to management.
- Gather data post-implementation to measure outcomes and impacts.
- Develop, analyze, recommend, and monitor reimbursement and provider strategies; prepare reports that measure the effectiveness of reimbursement and contracting terms and the influence they may have 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 various websites for reimbursement and policy changes, focusing on Government entities; make recommendations for implementation of changes.
- Communicate with various stakeholders, including physicians, hospital admin staff, other healthcare insurers, auditors, and other departments within the company.
- Annual review of compliance workflows, such as, SSAE, MAR. Actively participate in current audits; be able to respond comprehensively to auditor inquiries.
- Review provider contracts and ensure that claims system set ups accurately reflect fully executed, signed agreements.
- Respond to ad-hoc data requests from management, executive staff, and external departments.
- Performs all other miscellaneous responsibilities and duties as assigned or directed#LI-HybridJob Requirements
- Bachelor's degree and four years of related work experience; or an equivalent combination of education and related work experience.
- Demonstrated budgeting, forecasting, and variance analysis skills
- Demonstrated working knowledge of managed care/health care business processes, systems and application for claims payment, network, and provider contract administration.
- Demonstration project management skills
- Basic knowledge of Microsoft Office applications. Including but not limited to Word, Outlook, and Power Point.
- Advanced working knowledge of Microsoft Excel.
Job Details
Job Type: Full-time
Category: Accounting / Finance
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