More than 5 years of experience required
HEALTHCARE PARTNERS MEDICAL GROUP , a division of DaVita HealthCare Partners , Inc. (DVA: NYSE), is a top-rated southern-California medical group and is widely recognized for its achievements in clinical excellence and patient satisfaction. Founded in 1992, we have grown to provide care for more than 660,000 patients throughout Los Angeles and Orange counties. We own and operate 66 medical offices, and our affiliated physician network consists of more than 6,000 primary care physicians and specialists who represent the diversity of the areas we serve. HealthCare Partners also owns urgent care centers, walk-in care centers, and ambulatory surgery centers. In addition, we operate affiliated physician groups in Florida, Nevada, and New Mexico. HealthCare Partners has been recognized nationally for healthcare innovation and excellence.
We are committed to bringing the benefits of coordinated care to our patients and to taking a leading role in the transformation of the national healthcare delivery system to assure quality, access, and affordable care for all.
If you're looking to make a difference with a large, financially stable, well-recognized medical group, HealthCare Partners may be the employer for you. HealthCare Partners was voted one of the “Best Places to Work” in Los Angeles County and Orange County in 2012.
As part of our continued growth, we are seeking to add:
SENIOR FINANCIAL ANALYST 2 – HEALTH PLAN ANALYSIS AND FINANCIAL REPORTING – HEALTHCARE REQUIRED – Excel – Access – SQL Server – Risk Pools – Claim Lags / IBNR Estimates – HCC's
This new, senior job title and position was created to increase our capability for advanced and rapid analysis and assessment of institutional risk pool data and perform other key financial analysis for management. This is required in part by HCP’s transition from private to public company November 1, 2012, with accelerated monthly financial statement closing dates and quarterly review of financial statements by external auditors.
· Provide high-level financial analysis to HCP management for financial statements (particularly HMO revenue) and decision-making in health plan contracting and related areas. Key areas include institutional risk pools, professional and institutional capitation, integration of newly-acquired medical groups into HCP financial processes, and special analyses.
· Requires experience in compiling and analyzing claims payment lags, estimating completion factors, and making claims Incurred but not Reported (IBNR) estimates.
· Analyzes institutional risk paid claims data by health plan, HCP service area, and service type to quickly identify expense trends and possible corrective action for problem areas.
· Requires ability to quickly and accurately analyze health plan interim and final institutional shared risk pool reports and produce independent IBNR and net revenue estimates. This includes use of health plan claims-level detail to develop claims lags, completion factors, and independent IBNR estimates, as well as analysis of risk pool funding and comparison of accrued expenses and funding versus those reported by health plans.
· Requires experience in interpreting and analyzing health plan contract terms related to payments to medical groups and hospitals. These include capitation, institutional and pharmacy risk pools, and P4P and similar quality incentive programs.
· Requires advanced hands-on skills in Microsoft Access and Excel, with strong preference for basic SQL programming abilities.
· Requires ability to clearly communicate in both written and oral presentations and good inter-personal communication skills.
· Plays vital role in quarterly reviews and annual audit of company financial statements by external auditors.
· Completes monthly processes for professional capitation, risk pool revenue estimates, and health plan incentives for one or more of HCP’s contracted health plans. Works independently with health plan finance and contracting staff to obtain data and amounts due HCP.
· Provides analyses and data supporting recovery of risk pool overpayments and other amounts due HCP.
· Knowledge of the CMS Medicare Advantage capitation model, including risk adjustment methodology (using HCCs), preferred.
· Requires willingness and ability adapt to changing priorities and aggressive project deadlines. Requires strong project management skills to ensure that projects are completed on time and within budget.
· Works under supervision of the Director, Health Plan Analysis, and the Manager, Health Plan Analysis.
· Forecasts health care expenses and revenues. Creates ad hoc reports and completes special projects for senior management.
· Develops applications and/or reporting databases for collection of data using MS Access, Visual Basic, SQL, etc. in order to streamline processes and improve productivity.
· Requires Bachelor’s degree in Finance, Accounting, Business, IT, or related field. Master’s degree preferred.
· Requires strong understanding of the financial structure and business practices of the managed care industry.
· Requires 5 - 7 years of experience in HealthCare financial analysis, including Excel, Access, and SQL Server.
We offer a competitive salary and benefits program including Health, Dental, Vision, employer-matching 401(k), Continuing Education, Tuition Reimbursement, free Basic Life and AD&D insurance, company paid Long Term Disability, a generous Paid Time Off schedule, and more.
HealthCare Partners - 20 months ago
Since 1992, HealthCare Partners has been committed to developing innovative models of healthcare delivery that improve our patients' quality...