About the role
- Reporting, Research & Analysis
- Analyzes and forecasts premium revenue, risk adjustment payments, and other revenue streams related to lines of business using prescribed guidelines or policies.
- Gathers, validates, and interprets financial and enrollment data from internal and external sources.
- Supports RAF and financial data needs of program driving accurate coding and documentation to optimize revenue from evaluation and interpretation of the information.
- Runs and maintains financial models to assess the impact of regulatory changes, enrollment trends, and market dynamics on revenue.
- Variance analysis: identify and explain variances between actual and projected revenue.
- Collaborates with actuarial, finance, compliance and operations teams to ensure accurate revenue recognition and reporting.
- Compliance & Documentation
- Ensure all revenue analysis and reporting adhere to internal policies and regulatory guidelines.
- Develops and maintains appropriate documentation of desktop procedures for reconciliation and audit needs.
- Maintains working level knowledge of revenue structures and regulations.
- Leadership & Continuous Improvement
- Identify gaps and assist in implementing process enhancements to improve the accuracy and efficiency of revenue analysis.
Provide informal guidance to new team members.
- Identify gaps and assist in implementing process enhancements to improve the accuracy and efficiency of revenue analysis.
- Performs all other miscellaneous responsibilities and duties as assigned or directed.
#LI-Hybrid
- Bachelor's degree and four years of related experience; or an equivalent combination of education and related work experience.
- Strong oral and written communication skills for presenting complex information.
- Working knowledge of the techniques used to present financial or statistical data.
- Working knowledge of claims, health plan financial data, and health industry structure.
- Intermediate working knowledge of Microsoft Office applications, including but not limited to Word, Excel, Outlook, and PowerPoint.
About this listing
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