DaVita Financial Analyst, Senior I in EL SEGUNDO, California

Financial Analyst, Senior I

Description

DaVita Medical Group manages and operates medical groups and affiliated physician networks in California, Nevada, New Mexico, Florida, Colorado and Washington in its pursuit to deliver excellent-quality health care in a dignified and compassionate manner. As of June 30, 2016 DaVita Medical Group (formerly HealthCare Partners) provided integrated care management for approximately 760,000 patients. DaVita Medical Group’s leadership development initiatives and social responsibility efforts have been recognized by Fortune, Modern Healthcare, Newsweek and WorldBlu.

We are committed to bringing the benefits of coordinated care to our patients and to taking a leading role in the transformation of the national healthcare delivery system to assure quality, access, and affordable care for all.

If you're looking to make a difference with a large, financially stable, well-recognized medical group, DaVita Medical Group may be the employer for you.

OVERVIEW OF THE POSITION:

Responsible for data gathering, manipulation, reporting, evaluation and recommendations related to an assigned area which may include health plan, internal or sub-contractor analysis. Maintains systems and models to forecast the financial effects of health plan, contracting or operational activities.

ESSENTIAL FUNCTIONS:

Consistently exhibits behavior and communication skills that demonstrate HealthCare Partners’ (HCP) commitment to superior customer service, including quality, care and concern with each and every internal and external customer.

Health Plan Analysis:

  • Maintains a solid working knowledge of all health plan contracts and their assignments to various client entities.

  • Maintains and assists in developing effective controls to monitor health plan financial performance and assures adherence to all contract financial provisions.

  • Serves as a liaison with health plan representatives regarding implementation of contract financial terms.

  • Develops and implements models to predict health plan performance.

  • Implements health plan reporting including enrollment, capitation, pharmacy, hospital fund and other factors. Implements other additional health plan reporting as dictated by the current needs of client organizations.

  • Ensures supportability of health plan revenue accruals and consistency to general ledger entries.

  • Recommends revenue enhancement or cost reduction strategies in relation to health plan management and contracting.

  • Implements models and/or systems which assure parity in allocations between the various entities.

  • Develops audit procedures and systems for health plan financial activity for assigned plans which identifies discrepancies and maximize recovery.

  • Assures receipt of all health plan reports according to contract and historical schedules. Follows-up on missing or erroneous reports within 30 days.

  • Protects client rights by documenting unresolved health plan issues including quantification of financial effects where pertinent.

Internal Consulting:

  • Maintains systems to allow for ease of data retrieval and manipulation from a variety of sources including claims payment, utilization management, health plan risk pools, subcontractor capitation, internal changes, subcontractor risk pools and others as necessary.

  • Develops subcapitation and risk pool models. Develops systems to assure accuracy and timeliness of subcapitation payments and risk pool reconciliations.

  • Develops financial models for new ventures.

  • Develops models to evaluate provider contract proposals.

  • Performs historical studies to be used for forecasting future costs.

  • Identifies trends in claims expenses and recommends methods for reduction.

  • Performs research on industry performance measures for evaluation of client performance.

Other Duties:

  • Assists in the development of departmental policies and procedures.

  • Ensures accuracy and readability of individual projects.

  • Uses, protects, and discloses HCP patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards.

  • Performs additional duties as assigned.

Qualifications

EDUCATION:

  • Bachelor’s degree from a four-year college and/or a professional certification requiring formal education beyond a two-year college.

  • Master’s degree preferred.

EXPERIENCE:

Minimum:

  • Over 1 year and up to and including 3 years of experience.

Preferred:

  • 1 year healthcare experience.

  • 1 to 2 years analytical and/or financial experience.

KNOWLEDGE, SKILLS, ABILITIES:

  • Computer literate.

  • Proficient in Microsoft applications.

  • Excellent verbal and written communication skills.

DaVita Medical Group is an equal opportunity/affirmative action employer. As such, DaVita Medical Group makes hiring decisions solely on the basis of qualifications and experience, and without regard to age, race, color, religion, sex, gender identity, sexual orientation, national origin, disability or protected veteran status.

We maintain a drug-free workplace and perform pre-employment substance abuse testing and background verification checks.

DaVita Medical Group will consider qualified applicants who have criminal histories in a manner consistent with the law.

Primary Location CA-EL SEGUNDO - 90245

Req ID: 309510