Senior Financial Analyst - Health Plan

 
Position: Senior Financial Analyst - Health Plan

Job ID: 150547

Location: US-TX-Bellaire

Department: Admin - HP Finance

Talent Area: Finance

Full/Part Time: Full-Time

Regular/Temporary: Regular

Shift: 8a - 5p

About Texas Children's Hospital

Founded in 1996, Texas Children’s Health Plan is the nation's first health maintenance organization (HMO) created just for children. We provide STAR/Medicaid and Children's Health Insurance Program (CHIP) to pregnant women, teens, children and adults in Houston and surrounding areas. Currently, the Health Plan has more than 375,000 members who receive care from our network of more than 1,100 primary care physicians, 3,200 specialists, and 70 hospitals. Texas Children's Health Plan is also the largest combined STAR/CHIP Managed Care Organization in the Harris County service area.   To join our community of 14,000+ dedicated team members, visit texaschildrenspeople.org for career opportunities. You can also learn more about our amazing culture at infinitepassion.org.   Texas Children’s is proud to be an equal opportunity employer. All applicants and employees are considered and evaluated for positions at Texas Children's without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, gender identity, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.

Summary:

We are searching for a Senior Financial Analyst — someone who works well in a fast-paced setting. In this position, you’ll assist in maintaining the financial and statistical records of the health plan, ensuring that executives, management, and the board can continuously measure the health plan performance relative to its goals and strategies.

 

Think you’ve got what it takes?



Responsibilities :

  • Ensure that monthly source data validates current membership, retroactive membership adjustments, and payment amounts, according to contracted rates and membership distribution
  • Review monthly membership and payment amounts to resolve errors and discrepancies, and identify issues that need attention
  • Review monthly membership and revenue amounts, ASO revenue and receivables, and cash activities in the ledger
  • Prepare documentation required to obtain payments owed to the health plan and any supplemental payments available under contract provisions
  • Reconcile claims expense to lag schedules, calculate IBNR, and reconcile accrual-based expense totals to actual cash distribution
  • Prepare claims for recovery experience and evaluate the cost/benefit analysis
  • Reconcile revenue/medical expense amounts reported for the general ledger, financial reporting, decision support, and regulatory reporting
  • Prepare schedules as assigned for monthly, quarterly, and annual reporting of membership, revenues, and medical expenses by product
  • Research and respond to inquiries from management and other departments


Qualifications:

  • Bachelor’s degree in accounting, finance, or business administration required
  • 5 years’ experience in accounting or analytical work required
  • Master’s degree or CPA certification can substitute for 2 years’ experience


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