Responsible for providing financial analysis and maintaining key databases in a SQL Server environment utilizing SQL Query. Perform health care financial data analysis and reporting in accordance with regulatory requirements. This individual will be responsible for research, collection and analysis of the Plan's utilization and other health care data to coordinate data analysis which will enhance financial data.
Scope of Role & Responsibilities - Develops data tables and participates in analyses of project requests in support of the Finance Department.
- Recommends programs, practices, and standards to facilitate uniform application of electronic data.
- Prepare financial analyses on various aspects of the financial operations of the Plan including revenues, expenses, utilization, and membership.
- Supports the Department Analytical Staff
- Prepare schedules and worksheets for the Plan's regulatory financial reporting requirements (MMCOR, MLR, VBPTR).
- Prepare profit and Loss Statements
- Prepare revenue analysis
- Monthly, quarterly, yearly medical expense reconciliation
- Prepare quarterly review presentations
- Prepare projection analyses on claims and utilization, including underlying trends and risk analysis
- Creating detailed analysis outlining findings, opportunities, and solutions for the end user
- Gathering, interpreting, and using complex data to develop actionable items
- Research, analyze and report different trends
- Dashboard creation and maintenance
- Complex data mining
- Special projects and other related duties as assigned
Required Education, Training & Professional Experience - Bachelor's Degree with a minimum of 2 years of experience Industry related (business, health care, consulting, insurance, government) or relevant coursework
- SQL query experience preferred
- Complex formula and data tabulation Excel experience preferred
- MMCOR experience strongly preferred
- VBA experience strongly preferred
- MLR experience strongly preferred
Professional Compentencies - Integrity and Trust
- Customer Focus
- Functional/Technical skills
- Written/Oral Communication
#MPH50
#LI-Hybrid
