Supports provider payment operational management by providing information, responding to questions, and resolving complex problems and issues
Responsible for Financial internal control and policy and procedure development and documentation.
Responsible for weekly provider payment process and report generation and reconciliation.
Responsible for daily management of provider AR account balances through the timely processing of Action Notices into the FirstFinancial claims payment system.
Responsible for semi-annual management of uncashed checks and escheatment.
Preparation of monthly bank reconciliation.
Responsible for finance SLA monitoring and supporting documentation.
Manage the cadence and completion of the provider correspondence and mail merge process.
Reconcile and balance the series of client reports.
Primary responsibilities include analyzing costs, preparing financial reports and providing recommendations to leadership for lines of business according to established policies, guidelines and methodologies. Prepare journal entries and analyses in conjunction with month end close process and meet monthly deadlines.
Depending on area supporting, duties may vary.
Analyzes complex financial information and reports; provides accurate and timely financial recommendations to management for decision making purposes.
Develops sophisticated financial models. Provides recommendations based upon evaluation of financial trends and forecasts.
Evaluates and monitors the efficiency and performance of programs, ensuring program execution is on target.
Manages dashboard reporting by tracking monthly, quarterly and annual revenue and expenses.
Obtains a thorough understanding of operating infrastructure of Strategic Business Unit(s) (SBUs) operations to be able to proactively analyze and identify opportunities for cost savings and revenue enhancements.
Regularly reviews historical operating results and proactively identifies and analyzes potential revenue enhancement and cost saving opportunities.
Performs a variety of pro forma financial and operating analyses as requested to support proposals.
Reviews and understands fluctuations across SBUs in delivering cost of care and variations in cost of care. Differentiates impact of rate versus utilization variations.
Supports SBUs by providing information, responding to questions and resolving complex problems and issues.
If supporting Medicare Part D, will be responsible for implementing CMS requirements related direct and indirect plan remuneration, plan to plan reconciliation, monthly membership reports, coverage gap discount program, medical loss ratio reporting, fiscal soundness reporting, audit assistance and analysis of drug utilization and other costs trends.
Other special projects as assigned.
Other Job Requirements
Responsibilities
Requires financial analytical experience and demonstrated health care industry knowledge OR financial analytical experience and understanding of federal acquisition regulations if supporting Magellan Federal.
Ability to understand and analyze complex data sets and frame it to actionable analysis.
Understanding of the financial structure and business practices of the managed care industry OR federal acquisition regulations if supporting Magellan Federal.
Strong PC skills are essential, with advanced skills in Excel and Hyperion Essbase or other large enterprise financial software.
Roles supporting Magellan Federal require working knowledge of compliance requirements and accounting complexities
of federal government contracting, including Federal Acquisition Regulation (FAR) and Cost Accounting Standards) CAS.
General Job Information
Title
Financial Analyst II MediCal
Grade
23
Work Experience - Required
Finance
Work Experience - Preferred
Education - Required
Bachelors - Accounting, Bachelors - Finance
Education - Preferred
Masters
License and Certifications - Required
License and Certifications - Preferred
Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
