Financial Analyst
4 days ago
We are seeking a highly skilled Financial Analyst to join our team at Wellmark, Inc. as a Provider Reimbursement specialist. As a key member of our Health Network team, you will play a critical role in creating, implementing, and maintaining provider reimbursement strategies, including financial reporting and analysis for all providers contracted with Wellmark.
Key Responsibilities- Support provider reimbursement initiatives by reviewing and calculating fee schedules paid to healthcare providers.
- Research, document, monitor, and implement provider reimbursement-related activity and initiatives, including financial reporting and comprehensive data analysis.
- Perform routine financial analysis for Wellmark leadership to monitor reimbursement methodologies for effectiveness.
- Apply qualitative and quantitative techniques to interpret provider data and provide pricing recommendations as appropriate.
- Develop and maintain positive professional relationships with Network Engagement and Health Network to provide proactive communication of changes.
- Serve as a consultant in collaboration with Network Engagement to provide reimbursement guidance and expertise to providers and applicable stakeholders.
- Configure, transfer, and monitor data that is being processed in the provider payment systems.
- Bachelor's degree or direct and applicable work experience.
- 4+ years of financial analytical experience; OR 3+ years of financial analytical experience with 1+ year of healthcare, health insurance, or related industry experience.
- Demonstrates ability to anticipate and analyze long-term reimbursement model outcomes.
- Excellent critical thinking and creative problem-solving skills.
- Strong conceptual, strategic thinking skills.
- Identifies and implements continuous improvement opportunities.
- Strong verbal/written communications skills.
- Effectively builds relationships, influences, and solicits cooperation from others.
- Proactive self-starter with strong organizational, prioritization, and time management skills.
- Healthcare, health insurance, or related industry experience.
- Knowledge of Wellmark and/or national recognized provider reimbursement strategies.
- Understanding of Wellmark products, policies, and processes.
- Claims processing knowledge.
- Tableau, SAS EG, and/or SQL experience.
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