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Unit Cost Analyst I (Provider Reimbursement) - Detroit
Requisition #: 93663
Status: Full-Time with Full-Time Benefits (40 Hours)
Business Unit: Health Alliance Plan (HAP)
Shift: Days
Department: Provider Reimbursement
Weekends: No
Job Family: Accounting/Finance
Job Function: Business (Non-Clinical)
Campus/Job Location: Health Alliance Plan (HAP) - Detroit
Location (State/City): US-MI-Detroit
More information about this position
Overview:
Henry Ford Health System, one of the largest and most comprehensive integrated U.S. health care systems, is a national leader in clinical care, research and education. The system includes the 1,100-member Henry Ford Medical Group, six hospitals, Health Alliance Plan (a health insurance and wellness company), Henry Ford Physician Network, a 150-site ambulatory network and many other health-related entities throughout southeast Michigan, providing a full continuum of care. In 2013, Henry Ford provided $314 million in uncompensated care. The health system also is a major economic driver in Michigan and employs more than 23,000 employees. Henry Ford is a 2011 Malcolm Baldrige National Quality Award recipient. The health system is led by CEO Nancy Schlichting. To learn more, visit HenryFord.com
Responsibilities
PRIMARY OBJECTIVE
Complete comprehensive, quantitative, and qualitative analytics as it relates to the organizations contracted network arrangements in an effort to efficiently and accurately support Financial Services reporting requirements. The position will provide expertise in mining internal data, writing analytical reports, creating automated processes and procedures, and making recommendations for meeting reporting goals. The position will collaborate with data stewards and subject matter experts to ensure financial goals are met. The position will provide analytical and technical expertise to other internal departments. The position will assist in presenting to and advising upper management and/or key stakeholders on issues and recommended solutions to Financial and Network Medical expense fluctuations.
DUTIES AND RESPONSIBILITIES
* Complete financial analysis for reporting associated with, medical loss ratios, network modeling, medical and pharmacy claim costs, base rate and actual revenue impacts, as well as adherence to audit requirements.
* Lead/Assist in yearly and ongoing CMS Bids process and analysis.
* Provide financial and technical analytics related to data analysis and data mining.
* Provide input to management regarding configuration issues and impacts. Participate in change management for Provider Reimbursement area
* Complete financial analysis and deliver well-organized reports to reflect key findings, analytic methods to determine such findings, future analysis and implications, and the identification of opportunities.
* Partner with IT, R3, Provider Development, Claims, Health & Network Management, and other areas to champion, develop, and monitor sound financial analysis methodologies for reporting and filing purposes.
* Participate in meetings and represent Provider Reimbursement on various corporate sub-committees and workgroups ensuring needs are met when upgrades/changes are made to the organizations systems and/or processes
* Communicate and document system changes to business units. Translate system functionality into business relevant language.
* Lead/Assist in Year End Audits. Liaise with all external auditors to meet audit requirements and deadlines.
* Other duties as assigned.
Qualifications:
REQUIREMENTS
Education:
* Bachelor's degree in Business Administration, Economics, Health Care, Finance, Information Systems, Statistics or other related field is required. Master's degree in related field
Experience:
* Minimum of three (3) years of progressive analytical experience in healthcare or managed care related setting with specific exposure to financial analysis and budgeting.
* Minimum one (1) year of experience in relational databases such as Oracle and Access, ad hoc reporting tools, and analytical processing tools. (Cognos Business Insight preferred).
* Minimum one (1) year experience with data interpretation, analysis, and reporting; clinical and financial data; budgeting and forecasting; trend analysis as it relates to medical costs.
Knowledge:
* Accounting and finance principles as they relate to medical claims and membership data
* Business statistics, reporting and database management
* Advanced technical skills which includes, but is not limited to MS Access, SQL and Excel.
* Knowledge of VBA and automation between MS products.
* Knowledge of data integration using ADO and ODBC connections.
* Strong analytical ability to introduce new ideas, processes, measures, and tools to improve medical expense tracking and reporting.
* Strong business acumen to quickly learn business processes and understand the technology requirements needed to support achieving financial goals.
* Commitment to collaborate with technical experts (data architecture, information architecture) to establish the technical vision and solution options.
* Excellent verbal and written communication and collaboration skills to effectively communicate with both businessand technical IT teams.
Assessments:
* Successful completion of the MS Excel and MS Access assessments with a score of 75% or better.
Benefits:
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Equal Employment Opportunity / Affirmative Action Employer
Henry Ford Health System is committed to the hiring, advancement and fair treatment of all individuals without regard to race, color, national origin, sex, sexual orientation, age, disability, religion, weight/height, marital status, familial status, veteran status or any other characteristic protected by law..
