Financial Analytics Lead - Medicaid Unit Cost

Profile

Description

The Financial Analytics Lead manages data to support and influence decisions on day-to-day operations, strategic planning and specific business performance issues. The Financial Analytics Lead works on problems of diverse scope and complexity ranging from moderate to substantial.

Responsibilities

The Financial Analytics Lead collates, models, interprets and analyzes data in order to identify, explain, influence variances and trends. Explains variances and trends and enhances modeling techniques. May possess financial or actuarial background. Advises executives to develop functional strategies (often segment specific) on matters of significance. Exercises independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision, uses independent judgment requiring analysis of variable factors and determining the best course of action.

The Financial Analytics Lead, Medicaid Unit Cost will perform a variety of reimbursement tasks for new Medicaid states including:


Researching and documenting reimbursement methodology
Pricing unlisted codes
Looking for trend mitigation opportunities


Will assist in updating Unit Cost Model for new markets. Build on reports that influence contracting and network decisions. Will become a subject matter expert in Medicaid Unit Cost trends and work across the Medicaid organization to provide unit cost insights.

Required Qualifications


Bachelor's Degree
Experience in managing data to support and influence decisions on day-to-day operations, strategic planning and specific business performance issues
Experience in compiling, modeling, interpreting and analyzing data in order to identify, explain, influence variances and trends
Explains variances and trends and enhances modeling techniques
Must be able to exercise independent judgment and decision making on complex issues regarding job duties
Ability to work under minimal supervision
Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Must have the ability to communicate across business areas and collaborate within the Actuarial space
Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Three or more years of healthcare experience


Preferred Qualifications


SQL experience
Experience with the Medicaid line of business
Experience working with Humana's systems


Work-At-Home Requirements


Must have the ability to provide a high speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense.
A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required.
Satellite and Wireless Internet service is NOT allowed for this role.
A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information


Scheduled Weekly Hours

40

Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ****

Company info

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