Medicaid Revenue Analytics Specialist II

Job Summary:

Prior experience in Managed Care will be required to be considered for this role.

The Financial Analyst II is responsible for preparing analysis for utilization and financial trends, costs, revenues, financial commitments and obligations incurred to predict future revenues and expenses; as well as understand financial impacts of decisions and communicate those to management.

Essential Functions:

• Prepare analysis for financial trends, revenues, financial commitments and obligations incurred to predict future revenues and expenses; understand financial impacts of decisions and communicate those to management
• Highly involved in the development, production, and validation of reports from detailed eligibility and revenue data
• Compile and analyze financial information, including but not limited to preparing the evaluation of medical contracts, product lines, generating and managing medical and administrative cost saving initiatives, etc.
• Ensure integrity of information obtained for analysis; keep an up-to-date knowledge of the computer information system
• Develop competitive analysis and present findings to senior management
• Prepare expected revenue and monitor monthly variances to identify trends
• Identify and research trends and patterns using standard departmental reports and databases, as well as leveraging other processes and data sources for data mining
• Make appropriate improvements to internal analysis processes ensuring that practices are in line with the overall goals of the organization
• Support the financial control environment by reconciling internal data sets vs information provided by the State (such as, reconcile enrollment files to reimbursement records, etc.)
• Utilize key analysis experience and knowledge to analyze and report medical, contract and administrative activity
• Make appropriate changes to ensure compliance with MAR, regulatory and other organization requirements
• Perform any other job duties as requested

Education and Experience:

• Bachelor of Science/Arts Degree in accounting, finance, economics, computer sciences or related field or equivalent work experience is required
• Two to Four (2-4) years of experience in financial field is required
• Managed care or healthcare experience is required

Competencies, Knowledge and Skills:

• SQL and/or SAS experience strongly preferred
• Advanced proficiency level with Microsoft Excel
• Proficient with Microsoft Office Suite, including Outlook, Power Point, Access and Word
• Familiar with a variety of analysis concepts, practices and procedures
• Relies on experience and judgment to plan and accomplish goals
• Perform a variety of tasks under general supervision
• Creativity and latitude (independent judgment) is required
• Ability to work with others and work independently
• Demonstrates analytical/problem solving skills to perform a variety of tasks, some of which may be complicated
• Possesses critical thinking/listening skills
• Ability to communicate with all levels of management
• Detail oriented

Licensure and Certification:

• Association for Financial Professionals (AFP) FP&A, or related certification is preferred

Working Conditions:

• General office environment; may be required to sit or stand for extended periods of time
• May be required to travel occasionally

Compensation Range:

CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type (hourly/salary):

Organization Level Competencies

• Create an Inclusive Environment

• Cultivate Partnerships

• Develop Self and Others

• Drive Execution

• Influence Others

• Pursue Personal Excellence

• Understand the Business

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an inclusive environment that welcomes and supports individuals of all backgrounds.