Financial Analyst - Healthcare

The Health Plan of San Mateo (HPSM), a managed care health plan, seeks a full time Healthcare Financial Analyst to perform health care data analysis and reporting which will help guide business decisions and strategies.

The essential duties & responsibilities will include the following:

• Collect, analyze, summarize and interpret health care data, including claims, capitation, member, and provider information.
• Develop and prepare decision support tools to advise HPSM on activities related to medical cost trends, utilization of medical services, and provider reimbursement.
• Complete analysis of high cost drivers of medical costs and identify the underlying unit cost and utilization trends.
• Prepare monthly and quarterly reports and executive dashboards on medical cost performance and trends.
• Calculate monthly reserves required for IBNR and present monthly IBNR analysis and recommendations to management.
• Complete required governmental reporting, including State health care cost reconciliations and CMS annual MLR filings.
• Conduct special analyses and projects at the direction of management for all lines of business as necessary.
• Perform other duties as assigned.

Requirements

Education and Experience: Bachelor’s degree in Economics, Finance, Statistics, Actuarial, or a health-related field of study.  Minimum five (5) years of financial and data analysis experience, with a focus in healthcare data analysis highly preferred.

Knowledge of: Principles and practices of financial management.  Complex data analyses.  Methods of report preparation, writing and presentation.  Statistical research, analysis and techniques.  Healthcare industry data reporting standards, terminology, and guidelines.  Medi-Cal and Medicare claims billing policies and procedure codes.  Personal computers with a proficiency in database management and Microsoft Office Suite applications, including Outlook, Word, Excel, Access and PowerPoint.

Ability to: Work with relational database concepts and applications.  Analyze and evaluate a variety of complex financial issues and recommend effective solutions.  Apply critical thinking and problem solving skills to complex analyses.  Prepare clear and concise reports.    Communicate analysis clearly and concisely in writing and verbally.    Interact and work effectively with other departments and management.  Achieve high degree of accuracy on all reports and analysis and possess excellent attention to detail.  Work with minimal supervision while managing multiple tasks and meeting established deadlines. 

Compensation & Benefits

Starting Compensation Range: - depending on experience.

Benefits Information: Excellent benefits package offered, including HPSM paid premiums for employee’s Medical, Dental and Vision coverage.  Employee pays a small portion of the dependent premiums (5%) for medical and dental benefits.  Additional HPSM benefits include fully paid life, AD&D, and LTD insurance; retirement plan (HPSM contributes equivalent of 10% of annual compensation); holiday and vacation pay; tuition reimbursement plan; onsite fitness center and more.