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Managed Care Report Analyst

1 month ago

San Diego, United States Sharp Healthcare Full time

[
**Hours**:
**Shift Start Time**:
8 AM
**Shift End Time**:
5 PM

**AWS Hours Requirement**:
**Additional Shift Information**:
Flexible on start/end time

**Weekend Requirements**:
No Weekends

**On-Call Required**:
No

**Hourly Pay Range (Minimum - Midpoint - Maximum)**:
$27.986 - $34.983 - $41.979

**What You Will Do**
To assist the Supervisor of Managed Care Capitation in providing management and related finance departments with ongoing managed care financial data and analysis for all medical groups and Sharp HealthCare.

**Required Qualifications**

**Preferred Qualifications**
- 2 Years Accounting or Finance experience in a healthcare environment.

**Other Qualification Requirements**
- Bachelor's degree in Accounting, Finance or related business field (equivalent experience in a healthcare environment may substitute for education) - Required

**Essential Functions**
- Audits incoming commercial capitation payments
Completes audits of incoming commercial capitation to verify accuracy of payments and identify discrepancies between capitation and eligibility files, and between capitation received and contracted provider agreements.
- Customer service
Investigates and researches issues or questions brought to Managed Care Finance's attention by customers regarding their data as well as being proactive in identifying potential issues related to month to month and year to year variances, etc. Works independently to maintain active relationships with customers by periodically assessing needs and levels of satisfaction with service.
- General support
Participates in the preparation of other analyses and reports as necessary. Involves creation of Monarch models, keying and/or copying of health plan data into MS Excel and MS Access files.
- Report management
Prepares and distributes various financial and statistical reports, including professional and hospital capitation reports, capitation trending reports, retroactivity reports, enrollment reports, changes by employer group/health plan, PMPM reports, and capitation summaries to be used in the monthly recording of membership revenue by each affected entity.
- Special projects
Assists Supervisor of Managed Care Capitation on special projects or duties as assigned, including analysis of financial data by entity and ad hoc analyses. Assists Capitation/Shared Risk Analyst in various projects related to all areas of capitation.

**Knowledge, Skills, and Abilities**
- Math skills to solve and analyze accounting and financial problems, calculate percentages, per unit values, variances, and percentage increases and decreases.
- Ability to effectively communicate verbally and in writing with all levels of staff as well as with external agencies.
- Ability to handle confidential details while exercising good judgment and discretion.
- Good interpersonal skills and telephone interactions.
- Personal initiative as exhibited by utilizing time between routine workloads, assisting co-workers with varying tasks, and asking supervisor for additional tasks.
- Knowledge of healthcare finance, terminology, and statistical reporting.
- Knowledge of information systems as it relates to accounting systems.

Sharp HealthCare is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability or any other protected class

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