Job Details
The Finance Manager will over the team of Analysts, oversee and develop SOP's and financial solutions, create and package financial products, lead transition of accounting functions and financial reporting into ERP system.
Responsibilities:
- Identify cost drivers and drill down with the Team utilizing paid claims reports to calculate claims cost
- Review lag report for claims paid and received
- IBNR model using appropriate methodologies
- Create summary reports for Hospital Capitation monthly, to ensure Analysts have captured in the financial reports accurately
- Preparation of Risk Pool summaries by line of business, Health plan and aid category.
- Review the preparation Risk Pool summary with combined health plans
- Oversee the preparation of Capitation summaries
- Lead preparation of the report of claims by month & type of service
- Create reports to present to hospital clients and Leadership
- Maintenance of daily cash flow and monthly bank reconciliation
- Review the preparation EOM financial and board packages
- Oversee the preparation of other financial packages to present for Joint Operations Meeting (JOM)
- Automation of data mining needed for financial reporting
- Validate queries through SQL
- Review hospital financial risk pools to ensure a complete understanding of the performance of each hospital risk pool and all factors that influence its performance
- Review Risk pool contracts and interpret them into a schedule of payments for tracking purposes and ensure timely settlement payments
Minimum Job Requirements:
Education: Bachelor s degree (Accounting/Finance)
Experience: 3+ years of Healthcare, Physician Organization or Health Plan, Hospital Finance and/or Health Plan experience
Strong understanding of provider and health plan contracting, delineation of risk, medical terminology and standard industry reimbursement methodologies required.