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Medicaid Financial Analyst

Medicaid Financial Analyst

Presbyterian Healthcare ServicesAlbuquerque, New Mexico, USA
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Overview

Presbyterian is seeking a Medicaid Financial Analyst

  • Serve as key individual contributor to review and analyze directives from the New Mexico Health Care Authority (HCA) for PHPs Medicaid program to ensure financial compliance review the adequacy of funding for each directive support provider rate implementations and perform provider rate reconciliations. This role will partner with multiple business areas within the health plan to ensure directive compliance and optimal financial performance.
  • Lead sessions for strategic and operational planning and implement outcome of plans and directives
  • This role will be involved in meetings where decisions are made and presentations are required for senior leadership the Board of Directors and / or other organizations within PHP.
  • Problem solver for urgent financial issues impacting the organization.

Were determined to take care of those working in healthcare.

Presbyterian is dedicated to improving peoples lives - the lives of our patients and the lives of our coworkers. Were a locally owned and operated which encourages supportive leadership that empowers employees. And we provide the opportunity to grow from entry-level to the most senior positions.

Why Join Us

  • Full Time - Exempt : Yes
  • Job is based at Rev Hugh Cooper Admin Center
  • Work hours : Days
  • Benefits : We offer a wide range of benefits including medical wellness program vision dental paid time off retirement and more for FT employees.
  • Benefits : PRN / PT (working less than a .45 FTE) employee benefits available for this position such as medical gym memberships and an employee wellness program.

    • Ideal Candidate :

  • CPA License and / or Masters degree.
  • Experience dealing with highly confidential information.
  • Interfaces with all levels of the organization including the CEO.
  • Collaborate and achieve actionable results through others.
  • Builds strong sustainable relationships.
  • Combination of technical financial and business knowledge and experience.

    • Qualifications

  • Bachelors degree in finance accounting.
  • Four years of health care finance experience or equivalent work experience.
  • Intermediate to expert MS Office skills with focus on PowerPoint and Excel
  • Business acumen to handle both complex situations and multiple responsibilities simultaneously

    • Responsibilities

  • Review directives from New Mexico Health Care Authority (HCA) to size financial impact
  • Partner with Medical Economics to review adequate funding for each directive
  • Support provider rate implementations by ensuring applicable provider or revenue / CPT code rates are implemented accurately as outlined in directives
  • Audit final implemented rates to ensure accurate payment on claims to providers and prevent over / under payment.
  • Reconcile Provider Rates in PHPs Claim System to ensure timely updates to monthly provided Medicaid Floor Rates from HCA and provider agreements
  • Respond to HCAs directive drafts regarding any issues or recommended draft corrections
  • Project management : Lead a variety of projects related to organizational undertakings related to financial objectives. Organize schedule plan and manage senior-level team activities. Create monitor and manage all timelines. Create presentations for senior level meetings and briefings. Develop agendas content and manage meetings and internal communication for various daily weekly monthly quarterly or annual meetings. Manage evolving requirements and course-correct as needed to achieve objectives. Gather input from members at all levels of the organization to generate and deliver presentations accurately and in a timely fashion. Utilize influence skills to achieve project objectives and support from senior leaders. Act on behalf of the Finance Director in a decision-making capacity on assigned projects as required. May act in place of Finance Managers when positions are vacant and during the hiring process
  • Strategic Planning : Provide and coordinate financial analysis for strategic initiatives identified by the Finance Director that are outside typical operations.
  • Prepare reports and craft consistent messaging for dissemination of any financial information. Provide backup support for the Finance Director or Managers as needed and / or attend meetings on their behalf.
  • Represent the Finance Director or Manager as required regarding business expansion and growth activities or strategy sessions.
  • Financial Support : Provide financial management consulting and analysis for the finance department and other departmental organizations throughout the company as required. Analyze complex data and present key trends in a compelling and easy to understand fashion. Produce executive level PowerPoint presentations for key meetings. Edit streamline and enhance presentations prior to distribution.
  • Technology : Provide leadership in the development and maintenance of finance data-marts and other planning and reporting tools and technologies for the finance organization.

    • Benefits

    All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical dental vision short-term and long-term disability group term life insurance and other optional voluntary benefits.

    Wellness

    Presbyterians Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges webinar preventive screening and more.

    Why work at Presbyterian

    As an organization we are committed to improving the health of our communities. From hosting growers markets to partnering with local communities Presbyterian is taking active steps to improve the health of New Mexicans.

    About Presbyterian Healthcare Services

    Presbyterian exists to ensure the patients members and communities we serve can achieve their best health. We are a locally owned not-for-profit healthcare system of nine hospitals a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908 we are the states largest private employer with nearly 14000 employees.

    Our health plan serves more than 580000 members statewide and offers Medicare Advantage Medicaid (Centennial Care) and Commercial health plans.

    AA / EOE / VET / DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.

    Maximum Offer for this position is up to

    USD $56.92 / Hr.

    Compensation Disclaimer

    The compensation range for this role takes into account a wide range of factors including but not limited to experience and training internal equity and other business and organizational needs.

    Required Experience :

    Key Skills

    Cognos,Forecasting,Hyperion,Microsoft Access,Pivot tables,Accounting,Analysis Skills,Microsoft Excel,Financial Analysis,Financial Modeling,Budgeting,Financial Planning

    Employment Type : Full-Time

    Experience : years

    Vacancy : 1

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    Financial Analyst • Albuquerque, New Mexico, USA