Financial Analyst

This is a fully remote position, open to applicants in California.

📋 Description

• Assist the manager in guiding the department to ensure precise system configuration, processing of capitation payments, accruals, calculation of shared risk pools, and recording of claims expenses.

• Analyze contractual agreements to guarantee system accuracy and compliance.

• Manage databases and ensure the accuracy of provider payments.

• Ensure data integrity for auditing and bidding processes across all entities.

• Facilitate and lead meetings within the department for audits, accruals, data analysis, annual CMS bids, capitation, and claims reserves.

• Supervise timely and precise settlements of shared risk pools and provide guidance on contract language.

• Serve as a liaison with Network Management, Shared Services, Claims, Legal, Actuary, Compliance, and Enrollment.

• Test, validate, monitor, and report on the capitation module, enhancing processes and supporting CMS guidelines and system upgrades.

• Maintain capitation and shared risk modules through configuration, documentation analysis, and system testing.

• Mentor team members and assist with escalated issues and tasks.

• Ensure timely and accurate monthly provider capitation payments.

• Create system documentation, process flows, and desktop procedures.

• Evaluate contractual agreements related to payment methodologies for capitated and shared risk arrangements.

• Address and resolve inquiries from Network Management.

• Compile and analyze historical financial data, identify trends, provide forecasts, explain processes, recommend actions, and enhance departmental processes.

• Provide detailed capitation and accrual data for CMS bids on a GAAP-to-incurred basis.

• Offer analytical support to Finance, Network Management, Pharmacy, and Health Care Informatics departments.

• Assemble and present complex capitation information, assumptions, and recommendations.

• Initiate membership and payment audits while ensuring the efficiency of the capitation process.

• Support SCAN's Vision and Goals and perform other assigned duties.

⛳️ Requirements

• Associate's Degree or Technical Degree or equivalent experience.

• 3-5 years of relevant experience.

• Works under minimal supervision.

• Addresses complex issues and problems, referring only the most complicated matters to higher-level staff.

• Possesses extensive knowledge of the subject matter.

• Provides leadership, coaching, and/or mentoring to a subordinate group without direct supervision.

• Advanced analytical abilities.

• Basic problem-solving skills.

• Strong communication and interpersonal skills.

• Proficiency in Microsoft Office Suite at an advanced level is required.

• A background check is mandatory.

🏝️ Benefits

• An annual employee bonus program.

• Comprehensive Wellness Program.

• Generous paid-time-off (PTO).

• Eleven paid holidays per year, in addition to 1 floating holiday and 1 birthday holiday.

• Excellent 401(k) Retirement Savings Plan with employer match and contributions.

• Strong employee recognition program.

• Tuition reimbursement.

• Equal pay, employee resource groups, inclusive benefits, and more.