Financial Analyst II-Capitation (Hybrid- Onsite/Remote, North Carolina) at Alliance Health in Morrisville, North Carolina

Job Description:

The Financial Analyst II for Capitation is responsible for accurate monthly capitated payments reconciliations, reporting and analysis.  Incumbents may analyze workflows and processes and institute new workflows and processes or make improvements to existing to achieve greater efficiency.

This position will allow the successful candidate to work a schedule which will include both onsite as well as remote work certain days of the week as approved by their supervisor.

Responsibilities & Duties

Analyze and Reconcile Capitation payments

• Ensure TBI and Innovations Accounts Receivable (A/R) accuracy by tracking updated information contained in subsequent monthly report data from the State and Alliance Slot Tracking Reports


• Update TBI and Innovations reconciliations as necessary with rate changes or discrepancies


• Attend weekly meetings with the State to resolve Capitation Reconciliation discrepancies should tickets be submitted


• Track and organize State changes in the PMPM rates overtime and make changes to other dependencies


• Complete reconciliations for capitated payment arrangements with subcontractors based on Alliance membership, contract agreements and submitted invoices

Complete Reports and monitor trends

• Complete A/R, Liability, Accrual and Capitated Payment reports used by accounting at month end close


• Complete the Monthly Membership Model using capitated payment data


• Submit State Capitation Reconciliation monthly reports and enter ServiceNow tickets relating to reconciliation discrepancies


• Complete monthly trend analysis report for review by management 


• Monitor trends for any unusual changes or increased/decreased growth


• Identify and drivers of variances and present findings


• Develop new KPI’s or insights into trend behaviors

Develop and Implement Processes, workflows, and reporting 

• Aid in development of processes for new vendor/subcontractors and complete related new desk procedures


• Create desk procedures for other processes and workflows


• Recognize areas that can be improved upon and establish new reporting that would be insightful and impactful for decision makers


• Innovate workflows to create a more sustainable and accurate process that can be repeated and documented

Collaborate with departments and sub-contractors to resolve member issues

• Responsible for assisting other units in resolving member errors or issues blocking capitated payments and access to services


• Liaise with subcontractors on capitated payment arrangements

Minimum Requirements

Education & Experience

Associates Degree in Business Administration, Finance, Public Policy, Hospital Administration, or related field and at least five (5) years of related experience in financial analysis with demonstrated capacity to independently draw inferences and to communicate findings or an equivalent combination of education and experience.

Or

Bachelor’s Degree in Business Administration, Finance, Public Policy, Hospital Administration, or related field and at least three (3) years of related experience in financial analysis with demonstrated capacity to independently draw inferences and to communicate findings or an equivalent combination of education and experience.

Additional Training Preferred:

A background in managed healthcare, insurance operations preferred

Knowledge Skills & Abilities

• Thorough knowledge of financial data analysis methodology, including the use of evaluation techniques and problem-solving procedure


• Advanced skills with Microsoft products, particularly Excel


• Ability to resolve complex problems that require the evaluation of alternative methods and solutions


• Ability to work independently 


• Ability to set objectives an prioritize workflows


• Ability to prepare concise and accurate reports


• Strong written and verbal communication skills


• Ability to work under pressure and meet established deadlines


• Ability to quickly learn the financial systems and applications used in the organization

Salary Range 

$58,967.33 to $101,510.73/Annually

Education

Preferred

• Associates or better in Business Administration

Skills

Required

• Analysis


• Communication


• MS Excel


• Microsoft Office


• Problem Solving


• Prepare Reports

See job description

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