Job Description

The Hospital Risk Pool Reporting Analyst leads the preparation and presentation of financial, clinical and business analysis. This includes the accurate quantification and measurement of clinical outcomes. In addition, other key responsibilities include the oversight and development of operating plans and financial solutions that promote an environment of effective decision-making, revenue enhancement, cost efficiency, and sound business practices. Works closely with other hospital teams to develop and package financial products and services catered to meet the specific needs of MPM customers. Ensures the effective and timely delivery of quality financial/information products and services to MPM clients. The financial analyst is a key liaison and "front-line" financial resource between hospital operations and Strategic Finance and serves to create a forward-focused guiding vision and environment of "no surprises" Duties and Responsibilities: * Develops systems to assure the timeliness if risk pool reconciliations. * Develops financial models for new ventures. * Performs historical studies to forecast future costs. * Develops subcapitation and risk pool models. * Develops models to evaluate provider contract proposals. * Identifies trends in claims expenses and recommends methods for reduction. * Coordinates requests for analysis from internal and external clients including assignment, mentoring and establishing timelines. * Performs research on industry performance measures for evaluation of client performance. * Develops and maintains systems that allow for ease of data retrieval and manipulation from a variety of sources including claims payment, utilization management, health plan risk pools, subcontractor capitation, internal charges, subcontractor risk pools and others. * Assures accuracy and timeliness of subcapitation payments. * Disperse reports to Hospital Client and MSO Financial Analyst * Prepare and submit any additional requested reports to Hospital Clients * Prepare EOM financial and board packages * Prepare ad-hoc financial analysis as requested by the Controller, CFO and/or the client * Prepare other financial packages and ad-hoc reports as need for Operations Meeting Minimum Job Requirements: * Bachelor's degree or an equivalent combination of education, training and experience is required. * 3+ years of Physician Organization or Health Plan, Hospital Finance and/or Health Plan experience. * Definitive understanding of provider and health plan contracting, delineation of risk, medical terminology and standard industry reimbursement methodologies required. Knowledge, Skills and Abilities Required: * Demonstrates advanced understanding and experience using Excel (VBA's, macros. Pivot tables, vlookup, hlookup), MS Access and other Microsoft Office Systems required. * Must be highly analytical and possess a strong grasp of finance concepts such as capital budgeting, discounted cash flow, financial statement analysis and forecasted. * Experience in and knowledge of CPT, HCPC, DRG, ICD-9, ICD-10 and NDC coding is a plus. * Ability to communicate clearly and effectively, work accurately, meet deadlines and provide effective reporting is required. * Excellent interpersonal skills required to develop and maintain effective working relationships across all levels within the organization. * Ability to work both independently and as part of a team. * Willingness to ensure the job is performed within specified parameters and deadlines is essential * Crystal/SQL knowledge and experience necessary * Knowledge of Mas200, Ez-cap a plus * Medi-Cal/Medicare/MHC knowledge is a must * Demonstrate ability to plan, organize and manage modest projects successfully. * Ensures accuracy and readability of for all team projects. * Requisite poise, judgment, and trustworthiness to represent MSO to internal and external groups * Must work effectively in a team environment and able a supportive contributor or leader in team matters. Must conduct him or herself professionally and be capable of developing and maintaining positive, service oriented relationships with all levels of healthcare professionals, both internal and external to VHS, as well as Board members, administration and others. * Must be able to plan, coordinate and prioritize resources. * Uses, protects, and discloses HCP patients' protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards. * Performs additional duties as assigned. Working Conditions and Physical Effort: * Regular and reliable attendance is an essential function of the position. * Work is normally performed in a typical interior/office work environment. * No or very limited physical effort is required. No or very limited exposure to physical risk. Company Description Management Service Organization (MSO) (Healthcare Industry)

Company Description

Management Service Organization (MSO) (Healthcare Industry)