Financ Analyst-Regulatory Repo

2 months ago

Houston, United States Harris Health System Full time
About Us

Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 Members with the following programs:
• Medicaid State of Texas Access Reform (STAR) program for low-income children and pregnant women
• Children's Health Insurance Program (CHIP) for the children of low-income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR
• Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre-existing conditions.
• Community Health Choice (HMO D-SNP), a Medicare Advantage Dual Special Needs plan for people with both Medicare and Medicaid that combines Medicare Part A and Part B benefits, Medicare Part D prescription drug coverage, and Medicaid benefits with additional health benefits like dental, vision, transportation, and more.

Improving Members' experiences is at the heart of every Community position. We strive every day to make sure that our Members have access to the high-quality health care they need and deserve.

Community is accredited by URAC for its health plan operations. We offer care management programs for asthma, diabetes, and high-risk pregnancy. An affiliate of the Harris Health System (Harris Health), Community is financially self-sufficient and receives no financial support from Harris Health or from Harris County taxpayers.

Job Profile

JOB SUMMARY
The Financial Analyst Regulatory Reporting participates in the review, analysis, and reporting of medical claims, pharmacy, Non-Fee for Service, and Capitation Premium Revenue. Candidate must display proficiency with Microsoft Excel and Microsoft Access as well as general Health Information Management principles. Duties also include routine and ad hoc reporting and database management support. This role requires an analytical mindset, great attention to detail and the ability to clearly communicate verbally and in writing outcomes from various financial analysis that will be delivered to various levels of management.

JOB SPECIFICATIONS AND CORE COMPETENCIES

Participate in the Month End Close Process for STAR, STAR+PLUS, CHIP, CHIP Perinatal, DSNP, and Marketplace. Research and resolve data discrepancies. Review reports for accuracy.

Participate in completion of deliverables to maintain compliance with the production of all State of Texas deliverables or other governing body in a timely manner.

Respond to data requests from Community's Actuary, Auditors, HHSC Finance, and HHSC Health Plan Management.

Data Maintenance and Reconciliation

Ad-hoc analysis

Assist teammates and completes other duties assigned by the Director of Financial Planning & Analysis, Controller, or CFO.

Stays informed on latest Federal Legislation and Regulation (e.g. HHSC, CMS, etc.)

QUALIFICATIONS:

Education/Specialized Training/Licensure: Bachelor's degree in finance, Accounting, Economics, Healthcare Administration, Business Administration, or related field required.

Work Experience (Years and Area): 1+ years financial analysis required

1+ Healthcare/Managed Care preferred

Software Proficiencies: Advanced proficiency in Excel, Basic knowledge of Microsoft Word, Outlook, and Power Point. SQL Server Management Studio and Relational Databases, QNXT

Job Family/Job Title Competencies
Problem Analysis
Attention to Detail
Taking Initiative
Above Average Verbal
Exceptional Verbal
Writing /Composing

Benefits and EEOC

Community employees' benefits are provided by Harris Health. These benefits are designed to provide you with flexibility and choices in meeting your specific needs.

Community is an Equal Opportunity Employer.

Harris Health System's benefits program is designed to provide you with more flexibility and choices in meeting your specific needs. Harris Health System's benefits program allows you to protect your income in case of illness, death and disability, and to help you save for retirement.

It is the policy of Harris Health System to provide equal opportunity for all applicants for employment regardless of political affiliation, race, color, national origin, age, sex, religious creed or disability. Applicants may request any reasonable accommodation(s) to participate in the application process.

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