Our client is an industry leading providing Health insurance programs for businesses and consumers alike. Their Finance department is essential to the ongoing efficiency of the organization and they wish to hire a Senior Financial Analyst with Medicare or Health Insurance Marketplace experience.
Essential daily duties will include:-
- Prepare operational and risk reports for management analysis.
- Review rate setting activity and coordinate with corporate and state.
- Oversee and validate pricing models and lead initiatives to identify inefficiencies and areas of development and improvement.
- Responsible for identifying medical cost trends and leadership of medical cost improvement initiatives.
- Perform financial impact analysis for new contracts and support negotiations
- Review monthly performance and financial results of the business unit and provide recommendations to senior management.
- Interpret and analyze claims, premium, and capitation and membership data to utilization analyses.
- Lead projects to completion by contributing to database creation, statistical modeling and financial reports.
- Plan, direct, and coordinate risk and insurance programs of establishments to control risks and losses.
- Strong financial and commercial acumen.
- Experience in claims and knowledge of risk adjusted revenue, member quality and provider reimbursement methodologies preferred.
- Bachelor's Degree in Finance, Accounting, Economics, Business Administration
- 5+ years of experience in Commercial Insurance OR Medicare healthcare finance.
- Strong financial analytics, decision science or actuarial experience.
- Knowledge of managed care information or claims payment systems preferred. Previous structured testing experience preferred. Product Management and SQL experience preferred
- In-depth knowledge of the health care industry, including financial principles, administration, provider, market and legislative requirements.
- Demonstrated leadership in developing a team.
- Must have strong communications, and people’s skills.
- Experience working with the development of robust operating cost models (excel).