Operations Financial Analyst

Alignment Healthcare

Orange County, CA, US
  • Job Type: Full-Time
  • Function: Accounting/Finance
  • Post Date: 01/10/2021
  • Website: alignmenthealthcare.com
  • Company Address: 4 Park Plaza Suite 500, Orange, CA, 92614

About Alignment Healthcare

Alignment Healthcare is redefining the business of health care by shifting the focus from payments to people. We’ve created a new model for health care delivery that cuts costs and improves lives by unraveling the inefficiencies of the current system to drive patients, providers and payers toward a common goal of wellness. Harnessing best practices from Medicare Advantage, our innovative data-management technology allows us to commit to caring for seniors and those who need it most: the chronically ill and frail. With offices and care centers across the country, Alignment Healthcare provides partners and patients with customized care and service where they need it and when they need it, including clinical coordination, risk management and technology facilitation. Alignment Healthcare offers HMO plan options to California residents through the Alignment Health Plan, and partners with select health plans in North Carolina and Florida to help deliver better benefits at lower costs.

Job Description

The Operations Analyst assists the Financial Planning & Analysis department in all areas of financial analysis with regard to the Company, its financial solvency, its cash flow, its various regulatory reporting obligations, its ongoing as well as new business relationships, and its overall financial performance.   

 

Essential Duties and Responsibilities

Essential duties and responsibilities include, but are not limited to:

  1. Assist with implementation of new expansion markets (reporting, system configuration, business processes, etc.);
  2. Prepares monthly PCP capitation reports for direct contracted providers, IPA in the new expansion markets;
  3. Review and validate “Alignment Provider Management Report” (APMR) internal system reporting data (revenue, capitation, supplemental JSA, claims, pharmacy, etc.);
  4. Maintain IPA/ Hospital/ Supplemental contract types, effective dates, percentages/ PMPM’s for APMR system configuration;
  5. Reviews monthly and annual capitation analysis, reconciliations and disbursements to IPA’s, reinsurance providers and ancillary medical service providers;
  6. Review allocation of monthly revenue and expense by state and county to support the Accounting Department journal entries into Great Plains;
  7. Review and validate “Provider Data Management” (PDM) implementation of new contract configuration setup in EZ-Member cap rate table. Assists with annual budget, bid preparation and prepare network development rate modeling and analysis;
  8. Supports Director and VP of Financial Planning & Analysis on all regulatory audits for CMS, the Department of Managed Healthcare, state and federal taxing authorities, etc.;
  9. Prepares and tracks IPA financial solvency for all affiliated risk-bearing organizations (“RBO’s”) to present and distribute to management team;
  10. Monitor affiliated risk-bearing organizations submission of financial statements quarterly & annual within 45 days from the end of the RBO fiscal year;
  11. Reviews DMHC’s notifications in regards to Corrective Action Plans (CAP) for existing IPA’s with whom the Company transacts business;
  12. Prepares various membership, revenue, and cost analyses by county for the Director and VP of Financial Planning & Analysis on both a monthly and ad-hoc basis;
  13. Acts as a liaison to the Information Technology Department for the creation of various database queries on utilization, membership, revenue sources, etc.;
  14. Develops and updates policies and procedures (including desktop procedures) for functional areas such as capitation, late enrollment penalties, LICS, etc.;
  15. Reports annual membership metrics to regulatory agencies (e.g. – DMHC) on all risk bearing organizations (“RBO’s”) with whom the Company transacts business;
  16. Reviews monthly and annual Plan-to-Plan (“P2P”) reconciliations for amounts payable to (and receivable from) other health plans
  17. Prepares and reconciles quarterly amounts received by (and due to) the Company with respect to the Coverage Gap Discount Program including follow up of payment discrepancies;
  18. Other special projects as assigned.

Supervisory Responsibilities

This position is highly visible and interacts with all levels of the organization – including Executive Management.  Although this position does not directly supervise staff, it is responsible for managing project timelines and deliverables from various areas of the Company.

Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.  The requirements listed below are representative of the knowledge, skill, and/or ability required. 

  1. Bachelor's degree in a finance or equivalent work experience;
  2. Advanced knowledge of Excel;
  3. 3 years of relevant finance experience;
  4. Healthcare experience preferred;
  5. Excellent communication and interpersonal skills; and
  6. An ability to explain financial matters in writing.

Skills and Abilities

  1. Language Skills:  Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations.  Ability to write reports, business correspondence, and procedure manuals.  Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general public.
  2. Mathematical Skills:  Ability to work with mathematical concepts such as probability and statistical inference, and fundamentals of plane and solid geometry and trigonometry.  Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations.
  3. Reasoning Skills:  Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists.  Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.
  4. Computer Skills:  At least an intermediate to advanced level of proficiency with MS Excel.
  5. Other Skills and Abilities:
    1. Good organization skills; ability to handle multiple assignments simultaneously.
    2. Good analytical skills
    3. Good interpersonal skills in a business setting.
    4. Good business writing skills.

Working Environment

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms. The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.

Alignment Healthcare, LLC is proud to practice Equal Employment Opportunity and Affirmative Action. We are looking for diversity in qualified candidates for employment: Minority/Female/Disable/Protected Veteran. If you require any reasonable accommodation under the Americans with Disabilities Act (ADA) in completing the online application, interviewing, completing any pre-employment testing or otherwise participating in the employee selection process, please contact [email protected] (function() { var ac = document.createElement('script'); ac.type = 'text/javascript'; ac.src = ('https:' == document.location.protocol ? 'https://' : 'http://') + 'click.appcast.io/pixels/grpeople1-1573.js?ent=8&t=' + new Date().getTime(); var s = document.getElementsByTagName('script')[0]; s.parentNode.insertBefore(ac, s); })();

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Disclaimer: Local Candidates Only
This company does NOT accept candidates from outside recruiting firms. Agency contacts are not welcome.