Financial Operations Analyst
Location: Remote-US, California US
Job Number: 7594
Workplace Type: Fully Remote
Position Title: Financial Analyst
External Description:
Position Summary:
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.
General Duties/Responsibilities (May include but are not limited to):
- Assist with implementation of new expansion markets (reporting, system configuration, business processes, etc.).
- Prepares monthly PCP capitation reports for direct contracted providers, IPA in the new expansion markets.
- Review and validate “Alignment Provider Management Report” (APMR) internal system reporting data (revenue, capitation, supplemental JSA, claims, pharmacy, etc.);
- Maintain IPA/ Hospital/ Supplemental contract types, effective dates, percentages/ PMPM’s for APMR system configuration.
- Reviews monthly and annual capitation analysis, reconciliations and disbursements to IPA’s, reinsurance providers and ancillary medical service providers.
- Review allocation of monthly revenue and expense by state and county to support the Accounting Department journal entries into Great Plains.
- 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.
- 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.
- Prepares and tracks IPA financial solvency for all affiliated risk-bearing organizations (“RBO’s”) to present and distribute to management team.
- Monitor affiliated risk-bearing organizations submission of financial statements quarterly & annual within 45 days from the end of the RBO fiscal year.
- Reviews DMHC’s notifications in regards to Corrective Action Plans (CAP) for existing IPA’s with whom the Company transacts business;
- 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.
- Acts as a liaison to the Information Technology Department for the creation of various database queries on utilization, membership, revenue sources, etc.
- Develops and updates policies and procedures (including desktop procedures) for functional areas such as capitation, late enrollment penalties, LICS, etc.
- Reports annual membership metrics to regulatory agencies (e.g. – DMHC) on all risk bearing organizations (“RBO’s”) with whom the Company transacts business.
- Reviews monthly and annual Plan-to-Plan (“P2P”) reconciliations for amounts payable to (and receivable from) other health plans.
- 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.
- Other special projects as assigned.
Supervisory Requirements:
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.
Minimum Requirements:
- 3 years of relevant finance experience
- Healthcare experience preferred
- Education/Licensure:
- Bachelor’s degree in a finance or equivalent work experience
- Other:
- Advanced knowledge of Excel
- Excellent communication and interpersonal skills
- An ability to explain financial matters in writing
- 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.
- 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.
- 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.
- Computer Skills: At least an intermediate to advanced level of proficiency with MS Excel.
- Other Skills and Abilities:
- Good organization skills; ability to handle multiple assignments simultaneously.
- Good analytical skills.
- Good interpersonal skills in a business setting.
- Good business writing skills.
Work 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.
Essential Physical Functions:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Pay Range: $75,000 - $80,000 annually.
City: Remote-US
State: California
Location City: Remote-US
Location State: California
Community / Marketing Title: Financial Operations Analyst
Company Profile:
Alignment Health is revolutionizing health care for seniors by leveraging our world-class technology platform, innovative care delivery models, deep physician partnerships and our serving heart culture! From member experience professionals and clinicians, to data scientists and operations leaders, we have built a talented and passionate team that is deeply committed to our mission of transforming health care for the seniors we serve. Ready to join us?
At Alignment Alignment, delivering exceptional care to seniors starts with ensuring an exceptional experience for our over 1,300 employees. At the center of our employee experience is a culture where employees at all levels and across all teams are encouraged to share their unique ideas and perspectives. After all, when you can bring your authentic self to work, whether that’s in a clinical setting, our corporate office or a home office, creativity and innovation flourish! Another important part of the Alignment culture is a belief in continuous learning and growth. As a result, in this fast-growing company, you will find ample support to grow your skills and your career – with us.
EEO Employer Verbiage:
Please note: All clinical positions are contingent upon successful engagement with Alignment Health’s COVID-19 Vaccination program (fully vaccinated with documented proof or approved exception/deferral).
Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.
*DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at https://reportfraud.ftc.gov/#/. If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health’s talent acquisition team, please email [email protected].