Senior Financial Health Data Analyst II

• Design, develop and implement standard plan or provider financial and operational reports in response to customer requirements and business needs
• Lead and implement internal controls; facilitate definition of data and other information requirements; define efficient data assembly methods; and maintain adequate documentation for general reference and audit purposes.
• Interpret data and develop reports to communicate findings to senior management.
• Participate in project workgroups; facilitate definition of project requirements and deliverables; influence the progress of team activities and the successful implementation of the project.
• Document and share project activities, analyses, and decisions.
• Develop, analyze, recommend, and enhance workflow processes related to project deliverables.
• Evaluates alternative solutions/decision in light of the potential impact on internal/external resources; understand the resource implications of solutions and makes other recommendations; communicate status and recommendations to management.
• Gather data post-implementation to measure outcomes and impacts.
• Develop, analyze, recommend, and monitor reimbursement and provider strategies; prepare reports that measure the effectiveness of reimbursement and contracting terms and the influence they may have on overall program/plan cost and utilization.
• Analyze data and identify trends, patterns, or other notable issues with an eye for cost reduction opportunities.
• Monitor market trends to identify emerging opportunities or risks in business environments.
• Monitor various websites for reimbursement and policy changes, focusing on Government entities; make recommendations for implementation of changes.
• Communicate with various stakeholders, including physicians, hospital admin staff, other healthcare insurers, auditors, and other departments within the company.
• Annual review of compliance workflows, such as, SSAE, MAR.
• Actively participate in current audits; be able to respond comprehensively to auditor inquiries.
• Review provider contracts and ensure that claims system set ups accurately reflect fully executed, signed agreements.
• Respond to ad-hoc data requests from management, executive staff, and external departments.
• Performs all other miscellaneous responsibilities and duties as assigned or directed

#LI-Hybrid

• Bachelor's degree and four years of related work experience; or an equivalent combination of education and related work experience.
• Demonstrated budgeting, forecasting, and variance analysis skills
• Demonstrated working knowledge of managed care/health care business processes, systems and application for claims payment, network, and provider contract administration.
• Demonstration project management skills
• Basic knowledge of Microsoft Office applications. Including but not limited to Word, Outlook, and Power Point.
• Advanced working knowledge of Microsoft Excel.