Overview
The Senior Financial Specialist, Managed Care is responsible for analyzing managed care contract performance and providing financial insights that support strategic decision-making. This role develops financial models, performs reimbursement analyses, validates claim payments, and produces reporting used for contract negotiations, audits, and revenue optimization. The position also maintains key financial databases, investigates payment variances, and supports special projects that enhance organizational financial performance.
What You'll Do:- Analyze managed care contract performance and develop financial models to support negotiations and strategic decisions.
- Validate claim payments, investigate reimbursement variances, and identify opportunities to improve financial performance.
- Maintain financial reporting tools and databases to ensure accurate, reliable analysis.
- Partner with leadership and key stakeholders to provide actionable insights and support revenue optimization initiatives.
- Contribute to audits, contract reviews, and special projects that drive operational and financial improvements.
Who You Are:- Experienced healthcare finance professional with expertise in managed care, reimbursement, and claims adjudication.
- Strong analytical skills and comprehensive knowledge of revenue cycle and contracts.
- Proficient in financial reporting systems, databases, and healthcare reimbursement methodologies.
- Collaborative partner with excellent communication and problem-solving skills.
- Detail-oriented and committed to accuracy, operational excellence, and achieving organizational financial goals.
Licensure
Not Applicable
Education
Bachelor's Degree Accounting Required - And Bachelor's Degree Finance Preferred
Experience
4 Years Accounting/Finance - Accounting and Financial Analysis Or Accounting/Finance - Financial Analysis Or Accounting/Finance - Reimbursement Required
