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Financial Analyst

2 months ago

Des Moines, Iowa, United States Wellmark, Inc. Full time
About the Role

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.

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 stakeholders.
  • Configure, transfer, and monitor data that is being processed in the provider payment systems.
Requirements
  • 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.
Preferred Qualifications
  • 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.