Finance Analyst IV

Location: Atlanta, GA
Position Purpose: Compile and analyze financial information for the company. Lead various financial projects. Cost effectively manage the utilization of services and develop measures to track, trend and forecast related impacts of organizational strategic initiatives.
  • Review monthly performance and financial results of the business unit and provide recommendations to senior management.
  • Analyze and interpret claims, premium, membership and capitation to support management decision making.
  • Conduct financial impact analysis for provider contracts and support business negotiations.
  • Analyze claims to identify revenue maximization opportunities and prepare operational and risk reports for assigned function management review.
  •  Review rate setting activity with senior leadership and coordinate implementation plan with corporate and state.
  •  Responsible for identifying medical cost trends and leadership of medical cost improvement initiatives.
  • Lead risk adjustment projects to completion by contributing to database creation, statistical modeling and financial reports.
  •  Plan, direct, and coordinate risk and insurance programs of establishments to control risks and losses.
  • Strong financial and commercial acumen.
  • Experience in claims and knowledge of risk adjusted revenue, member quality and provider reimbursement methodologies preferred.
  • ‚ÄčKnowledge of managed care information or claims payment systems preferred. Product Management and SQL experience preferred.
 
Qualifications:
Education/Experience: Bachelor’s degree in related field or equivalent experience. 6+ years of experience in commercial insurance & Medicare healthcare finance specifically in the area of financial planning/ forecasting and budgeting, claims & data analysis, and revenue maximization experience.  Advanced knowledge of Microsoft Applications (including Excel and Access) required, project management experience and financial engineering preferred.
Tami Andrade Fitzpatrick
Senior Recruiter
720-930-4773
tami@proenlist.com
www.proenlist.com


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