The Healthcare Finance (HCF) department exists to monitor and improve the financial performance of Kelsey-Seybold's (KS) product lines and health plans. The HCF Analytics team is a customer service-focused department providing consultation to the KS executive team as well as to select operational and functional departments. The HCF Analytics team works closely with internal and external partners to identify revenue and cost savings opportunities, support new product and business development, ensure regulatory compliance, inform contract negotiations and complete reconciliation of incentive arrangements, claims, capitation, and premium payments with other payers, vendors and/or government entities.
The HCF department is adequately staffed by highly skilled, motivated and inquisitive individuals that deliver complex analysis of financial and utilization data to support revenue enhancement and identify cost savings opportunities. The Supervisor will oversee the work of a team of 1-3 analysts and closely collaborate with the Manager and Director of Healthcare Finance to oversee and provide financial data, reporting and other actionable information to the HCF Management Team and other departments regarding relevant business units, processes, products and/or service lines. The Supervisor is responsible for ensuring timely receipt and load of external data required for the team's analysis and reporting.
If you are located in Pearland, TX, you will have the flexibility to work remotely* as you take on some tough challenges.
Primary Responsibilities:- Oversight and production of recurring financial reports, financial reconciliations, and analysis required to understand the key drivers of the relevant business unit or service line
- Helping to develop and implement the systems and processes that are the foundation for reporting and analysis
- Coordinating the delivery of analytical support to internal customers including the Central Business Office, Pharmacy Services, Business Planning, Accounting, Managed Care Contracting, Claims, Marketing, and Utilization Management departments and partnering with the Business Intelligence team to automate and improve reporting
- Presenting findings and recommending solutions to internal and external customers and KS Executive team
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:- 5+ years of experience in data analysis, decision support, medical economics, healthcare informatics, or managed healthcare
- 3+ years of programming experience in SQL, SAS or similar application language
- 2+ years of experience supervising or managing teams and/or projects
- Experience writing, debugging and documenting complex queries against relational databases
- Experience participating in/leading system design and implementation initiatives
- Demonstrated ability to create and implement analysis/modeling that converts raw data into actionable business insights
Preferred Qualifications: - Experience in the healthcare industry and familiarity with healthcare systems (e.g., enrollment/eligibility, capitation, claims payment, etc.) with a Managed Care Organization (MCO)
- Experience with Medicare Part C or Health Insurance Marketplaces highly desirable, particularly with CMS risk adjustment models
- Experience in the healthcare industry with understanding of data in healthcare organizations (including claims data, ANSI 5010 837 data specifications, ICD10, Medicare Advantage, Health Insurance Marketplace, capitated payment models)
- Experience with Statistical Software (including SAS, R, Minitab, SPSS)
- Experience with reporting tools (including Crystal Reports and Microsoft Access)
- Knowledge of medical insurance products and basic underwriting concepts
- Familiarity with EPIC and Clarity reporting data warehouse
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $91,700 - $163,700 annually based on full-time employment. We comply with all minimum wage laws as applicable.
