Financial Analyst, RBE

2 weeks ago

Plano, United States Catalyst Health Group Full time
Job DescriptionJob Description

The RBE (Risk Bearing Entity) and MA (Medicare Advantage) Financial Manager will help our communities thrive by supporting Catalyst Health Group in a variety of financial initiatives, working under the direction of the Director, Financial Planning & Analysis

We are a culture that is unabashedly driven by purpose. We are making a difference to our patients and providers while growing at an accelerated rate. Every day, we support the health journey of patients by authentically living our core values: Purpose Driven, Relationships Matter, Serve Others First, and Inspire Creativity. If you love serving others and would like to make a material difference in an industry-transforming organization, then we invite you to apply to this role. We are recognized as one of the Top 100 Places to Work by The Dallas Morning News, and we have been awarded as one of the fastest-growing privately held companies by SMU Cox

Accountabilities

  • Dedicated FTE providing financial and analytical support to the Executive Director, Medicare Programs and our Risk Bearing Entity partnership with agilon
  • Monthly report reconciliation with agilon of capitation results, in partnership internally with the Performance Advocate Medicare (PAM)s, along with the agilon Finance team and IT, if needed; ensure accuracy of data and confirm process is streamlined and automated, where possible; identify any gaps in data
  • Monthly preparation and distribution of capitation results to physician practices
  • Monthly submission of payments to accounting team for processing in bill.com
  • Responsible for month-end close journal entries of all capitation, surplus and incentive calculations, including maintenance of accrual spreadsheet, by payor
  • Responsible for attending all JOC meetings with RBE/Payer to ensure proper accounting estimates for capitation, surplus and incentive-based accruals and recommend adjustments when needed
  • Maintain monthly accrual tracking spreadsheet by payor contract
  • Quarterly report reconciliation with agilon of BOI results, in partnership internally with the Performance Advocate Medicare (PAM)s, as well as the agilon Finance team and IT, if needed; ensure accuracy of data and confirm process is streamlined and automated, where possible; identify any gaps in data
  • Monthly billing to agilon for items qualifying for reimbursement, including appropriate general ledger coding and allocation by department
  • Monthly internal tracking of agilon billing and payments, including timely follow-up on delayed payments
  • Manage billing with payors and ensure timely payments
  • Monthly reconciliation of Long-Term Agreement (LTA) exclusivity payments in accordance with SOP
  • Prepare MA analysis related to business development and new opportunities, as appropriate
  • Provide support for Monthly Executive Meetings with agilon leadership, as requested by Executive Director
  • Maintain formal SOPs for processes supporting agilon flows, including reimbursements for technology, provider access, staff lease and other, as appropriate
  • Provide financial assumptions for updates to forecast and input into the quarterly financial surplus review, annual budget process, including alignment with agilon; required review of payor contracts and cash flow impacts
  • Coordinate and work across business units that impact RBE/MA results including accounting, revenue cycle, EMR applications, procurement and operations
  • Other duties and special projects as assigned

Role and Responsibilities:

  • Ability to tie MA operational metrics to financial performance of the business for Commercial, Network, Platform and CPG
  • Review and interpret monthly financial statements including the balance sheet, income statement and cash flow
  • Ability to gain confidence of and communicate with business unit leaders regarding RBE and MA performance
  • Strong research skills to ensure current with healthcare topics and impact on financial results, including impact on the future

Minimum Qualifications and Requirements:

  • Bachelor's Degree
  • Minimum of 5-7 years Industry and financial analysis experience
  • Power user of excel & relational databases; capable of building robust and detailed financial models and work with large amounts of data
  • Fluency in PowerPoint to translate business results to storytelling
  • Ability to work across multiple business units
  • Excellent communication and presentation skills; be comfortable interacting multiple stakeholders at different levels
  • Working knowledge of accounting procedures and principles including revenue recognition and accruals
  • Experience with general ledger functions and the month-end/year-end close process
  • Knowledge of medical reimbursement methodology and industry benchmark organizations such as MGMA
  • Previous experience working with NetSuite, or similar ERP
  • Knowledge of revenue cycle best practices and KPIs
  • Demonstrate ability to establish priorities and work independently without constant supervision

Preferred Experience:

  • Master's Degree
  • Previous experience managing projects across different departments
  • Previous experience working with an insurance payer and/or organizations who manage risk on value-based contracts
  • Ability to model recommendations in Tableau or other Business Intelligence Tool
  • Knowledge of Practice Management Systems and practice workflows

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