Coordinates and performs financial analyses and reporting, including compiling, reviewing, analyzing, evaluating, and customizing financial data for dissemination to management, financial organizations, governmental entities, and others requiring financial information. Provides support and guidance for Analysis staff.
CALCULATES PREMIUM AND CAPITATION RATES TO ENSURE GROUPS ARE CHARGED CORRECTLY AND PROVIDERS ARE PAID PROPERLY.
PREPARES REPORTS FOR MONTH END ACCOUNTING CLOSE.
- Calculates premium rates using experience rating/analysis methodologies, including jumbo groups and groups with customized benefits.
- Completes Requests for Proposal questionnaires when required.
PROVIDES SUPPORT IN PREPARATION OF THE ANNUAL BUDGET.
- Collects and analyzes data from the appropriate sources, identifies any unusual trends or issues, and resolves problems or discrepancies as needed.
- Prepares reports and/or presents relevant data in a timely, accurate, and user-friendly format (sub-reports, charts, graphs, etc.) that is appropriate for the desired result.
- Supports the monthly accounting close out process by preparing and reviewing journal entry information.
- Completes the calculation of monthly reserves (IBNR) for the review of the Underwriting Manager and Actuary when requested.
- Assists with and reviews the Premium Deficiency Reserve calculation (PDR) on a monthly basis.
SUPERVISES UNDERWRITING GUIDELINES AND PROCESSES.
- Collects and validates data required by in-house and consulting actuaries. Assists in the coordination of data requirements and collection with other departments (membership projections).
- Works with MIS to make necessary changes to membership reports in order to provide Marketing with accurate membership from which to project.
- Assists in verifying projection model output for accuracy and reasonableness.
PERFORMS OTHER POSITION APPROPRIATE DUTIES AS REQUIRED IN A COMPETENT, PROFESSIONAL AND COURTEOUS MANNER.
- Responsible for maintenance Stepwise rating software.
- Maintains department policies and procedures and the underwriting guidelines.
- Provides training and guidance on department policies and procedures as well as rating methodology to staff.
- Supports Financial Analysis staff. Provides input for hiring and evaluations of staff.
KNOWLEDGE SKILLS AND ABILITIES
- A Bachelor's degree (e.g., BA, BS, BSN, BSW) in Finance, Accounting or Statistics is required.
- Three to five years finance/healthcare or two to three years underwriting is required.
- Computer efficiency using various applications. Analytical and statistical knowledge and skills.
Experience: 3+ Years
Department: HPIOps Underwriting
Standard Hours Per Week: 40
Scott & White Healthcare is a not-for-profit health care system established in 1897. Scott & White is the principal clinical teaching...