Senior Health Care Financial Analyst

About Us:

Santa Clara Family Health Plan (SCFHP) is a local, community-based health plan dedicated to improving the health and well-being of the residents of Santa Clara County. Working in partnership with providers and community organizations, we serve our neighbors through our Medi-Cal and SCFHP DualConnect (HMO D-SNP) Health Care plans.

About the role:

The Senior HealthFinancial Analyst is responsible for performing finance responsibilities and analyzing a variety of health plan data. The incumbent aggregates large datasets, carries out functions in databases, and performs business and financial calculations.

Day to Day:

• Responsible for revenue and cost reconciliation activities using capitation invoices, eligibility files, claims and expense data and other relevant reports.
• Design and prepare reports that analyze the financial outcome of programs and make recommendations based on that analysis.
• Understand and track applicable regulatory and reporting requirements.
• Prepare reports required by regulatory agencies and ensure compliance with reporting requirements. Ensure accuracy and regulatory compliance for all materials or documents.
• Develop executive level reporting summarizing the financial, utilization and operational impacts of organizational initiatives.
• Analyze data to generate dashboard metrics and reports at required intervals (e.g., monthly/quarterly) for senior management, including medical loss ratios, medical costs, medical trends, and provider profiles.
• Use database skills to create queries, reports, and other output to produce analytics to support SCFHP’s business needs (e.g., financial, medical management, contracting).
• Retrieve and compile information, databases, and/or reports from internal and external sources.
• Support HEDIS and medical management analytical and reporting needs.
• Collaborate with Information Technology to validate report portal and data marts.

About You:

• Bachelor's Degree in Accounting, Finance, Business Administration, or related field; or equivalent experience, training, or coursework.
• Master’s Degree in Accounting, Finance, Business Administration, Health Care Administration is desired.
• Minimum three years of experience with the duties and responsibilities described above in Health Care.
• Superior analytical and qualitative skills and the ability to deal with complex problems/issues and large data sets.
• Relational database skills using various database tools.
• Strong working knowledge and proficient with Microsoft Office applications, particularly Access, Excel, PowerPoint, and Word.
• Knowledge of Health Care delivery and financing, especially with public programs.

Please review the full job description on our Career’s page:

https://phf.tbe.taleo.net/phf04/ats/careers/v2/viewRequisition?org=SANTCLAR2&cws=38&rid=2973

Job Type: Full-time

Pay: $104,280.00 - $161,634.00 per year

Benefits:

• 401(k)
• Dental insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Retirement plan
• Tuition reimbursement
• Vision insurance

Experience:

• Health Care: 3 years (Required)

Work Location: In person