Financial Analyst IV - Medicaid/Medicare Experience Required

Job Summary:

The Financial Analyst IV is responsible for leading and analyzing utilization and financial trends, costs, revenues, financial commitments and obligations incurred to predict future revenues and expenses; understand financial impacts of decisions and communicate those to management.

Essential Functions:

• Manage the development, production, and validation of reports from detailed claims, eligibility, pharmacy and clinical data
• Compile, analyze, and communicate financial and clinical 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
• Direct and develop competitive analysis and present findings to senior management
• Responsible for the development of membership projections, medical expense forecast and budget and monitor monthly variances to identify trends
• Proactively identify trends and patterns using standard departmental reports and databases as well as leveraging other processes and data sources for data mining
• Evaluate and 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
• Identify and lead initiatives to ensure compliance with MAR, regulatory and other organization requirements
• If applicable lead corporate finance and accounting initiatives for new business and programs
• If applicable collaborate with Finance Leadership, Enterprise Project Management Office (EPMO) and Business Development for the purpose of procuring new business and integrating that business into the existing market and product structure  
• If applicable work closely with Finance Leadership to coordinate the identification of resources with subject matter expertise and compilation of the requisite information necessary to procure, develop and oversee the launch of new markets and product development
• If applicable support the launch of new markets and product development by providing relevant insight to enable prioritization of deliverables based on market needs
• Mentor and development new associates
• 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
• Master of Business Administration (MBA) or other related post-graduate degree is preferred
• Minimum of  six (6) years of experience in finance, accounting, or other professional role with a focus on data manipulation and analysis is required
• Managed Care or healthcare experience is preferred

Competencies, Knowledge and Skills:

• Ability to lead and direct the work of others
• Results oriented decision maker that handles ambiguity and complexity well
• 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
• Subject matter expert in a finance domain with a broad understanding of analysis concepts, practices and procedures
• Relies on extensive experience and judgment to plan and accomplish goals
• Ability to lead and provide subject matter expertise to less experienced analysts in the department
• Wide degree of creativity and latitude (independent judgment) is required
• Demonstrates analytical/problem solving skills to perform a variety of complicated tasks
• Possesses critical thinking/listening skills
• Ability to communicate with all levels of management
• Detail oriented

Licensure and Certification:

• Certified Public Accountant (CPA), Certified Management Accountant (CMA), Association for Financial Professionals (AFP) FP&A, or related certification is preferred and provides credit for one year of related experience

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

• Fostering a Collaborative Workplace Culture

• 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 environment of belonging that welcomes and supports individuals of all backgrounds.