Capitation Data Analyst

4 days ago


Orange, California, United States Alta Hospitals Full time

Job Summary

The Capitation Data Analyst will work within the Decision Support Services department to analyze PCP and Specialist capitation payment data and health plan revenue payment data within a managed care organization. The ideal candidate will be responsible for communicating and disseminating guidelines and documentation related to PCP/Specialist capitation or Health Plan Revenue, creating relevant reports, and evaluating potential recovery.

Key Responsibilities

  • Compiles and validates capitation payment data or health plan capitation data to ensure payments are timely and accurate.
  • Drills down to identify capitation trends and collaborates with other departments to communicate and validate unexpected variances and resolve issues involving capitation payments.
  • Maintains data integrity of PCP/Specialty capitation and health plan revenue capitation SQL databases.
  • Develops and maintains routine and ad-hoc reports for internal review.
  • Performs and leads special projects as assigned.

Requirements

  • Bachelor's degree or equivalent education and experience in Finance or related field required.
  • Two to four (2-4) years of experience with capitation processing in an HMO managed services organization required.
  • One to two (1-2) years of experience with financial analysis experience in the healthcare environment required.

About Alta Hospitals

Alta Hospitals is a leading healthcare provider dedicated to delivering high-quality patient care and innovative medical solutions. Our team of experts is committed to making a positive impact in the lives of our patients and communities.



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