Manager of Service Funds & Provider Analytics
Universal Health Care - Saint Petersburg, FL

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Position Description: The Manager of Service Funds and Provider Analytics will be primarily responsible for the development and maintenance of programs regarding Risk Provider Reconciliation and Reinsurance coverage for all lines of business. S/He will be responsible for setting up, monitoring, and reporting on provider incentive/risk contracts, and the IPA/MSOs medical reinsurance (stop-loss) coverages. Calculate P&L for MSO. Position Responsibilities: Complete IPA/MSO set up from start to finish (contracting for MSO, track UHC process, meet weekly to ensure services provided are allowing MSO to engage with Provider opportunities) Prepare monthly reconciliations of IPA/MSO contracts Lead the preparation of Medicare provider contracts Responsible for the acquisition of reinsurance coverage Submit reinsurance claims for all lines of business and to conduct supporting analysis Submit reinsurance claims for IPA groups, including recovery allocation through the IPA providers service fund Coordinate quarterly meetings with IPAs & MSOs and maintain productive relationship with provider groups Liaison with IPAs & MSOs including provider education on reconciliation of the contract. Review and make recommendations on proposed incentive/risk arrangements. Ad-hoc reporting to conduct data analysis and validation
Skills, requirements and preferences: Knowledge of Microsoft office including Outlook, Word, PowerPoint Strong knowledge of MS Excel, Access Good analytics and accounting skills DRG/CPT/ICD-9 knowledge Strong communication skills, both written and verbal Proven capability in leadership and persuasion Ability to work autonomously as well as successfully cooperate within a team environment Must be able to work within tight deadlines Strong attention to detail Educational requirements and experience: Bachelors Degree required in Finance, Masters preferred 4-7 years related experience, preferably in a Medicare health care environment with previous incentive/risk contract reconciliation experience 3+ years experience managing and directing staff

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