Responsible for analyzing utilization and financial trends, costs, revenues, financial commitments and obligations incurred to predict future revenues and expenses
Manage the development, production, and validation of reports from detailed claims, eligibility, pharmacy and clinical data
Compile and analyze financial and clinical information, including but not limited to preparing the evaluation of medical contracts, product lines, generating and managing medical and administrative cost saving initiatives
Ensure integrity of information obtained for analysis; keep an up-to-date knowledge of the computer information system
Develop competitive analysis and present findings to senior management
Responsible for the development of membership projections, medical expense forecast and budget and monitor monthly variances to identify trends
Proactively identify trends and patterns using standard departmental reports and databases as well as leveraging other processes and data sources for data mining
Evaluate and make appropriate improvements to internal analysis processes ensuring that practices are in line with the overall goals of the organization
Support the financial control environment by reconciling internal data sets vs information provided by the state
Utilize key analysis experience and knowledge to analyze and report medical, contract and administrative activity
Make appropriate changes to ensure compliance with MAR, regulatory and other organization requirements

Requirements

Bachelor of Science/Arts Degree in accounting, finance, economics, computer sciences or related field or equivalent work experience
Master of Business Administration (MBA) or related post-graduate degree preferred
Minimum of four (4) years of experience in finance, accounting, or other professional role with a focus on data manipulation and analysis required
Managed Care or healthcare experience preferred
SQL and/or SAS experience strongly preferred
Advanced proficiency level with Microsoft Excel
Proficient with Microsoft Office Suite, including Outlook, Power Point, Access and Word
Familiar with a variety of analysis concepts, practices and procedures
Ability to lead and provide subject matter expertise to less experienced analysts in the department
Ability to work with others and work independently
Detail oriented

Benefits

Health insurance
401(k) matching
Flexible work hours
Paid time off
Bonus tied to company and individual performance
Comprehensive total rewards package

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools

data analysisfinancial analysiscost analysisdata manipulationbudget forecastingtrend analysisreport generationdata miningmedical contract evaluationadministrative cost saving initiatives

Soft Skills

detail orientedleadershipcommunicationcollaborationindependent worksubject matter expertise

Certifications

Bachelor of Science/Arts DegreeMaster of Business Administration (MBA)