Reporting, Research & Analysis
Analyzes and forecasts premium revenue, risk adjustment payments, and other revenue streams related to lines of business using prescribed guidelines or policies.
Gathers, validates, and interprets financial and enrollment data from internal and external sources.
Supports RAF and financial data needs of program driving accurate coding and documentation to optimize revenue from evaluation and interpretation of the information.
Runs and maintains financial models to assess the impact of regulatory changes, enrollment trends, and market dynamics on revenue.
Variance analysis: identify and explain variances between actual and projected revenue.
Collaborates with actuarial, finance, compliance and operations teams to ensure accurate revenue recognition and reporting.
Compliance & Documentation
Ensure all revenue analysis and reporting adhere to internal policies and regulatory guidelines.
Develops and maintains appropriate documentation of desktop procedures for reconciliation and audit needs.
Maintains working level knowledge of revenue structures and regulations.
Leadership & Continuous Improvement
Identify gaps and assist in implementing process enhancements to improve the accuracy and efficiency of revenue analysis.
Provide informal guidance to new team members.
#LI-Hybrid
Hybrid Work Environment - Must reside in Hawaii
Pay Range: $59,000 - $116,000
Note: Individuals typically begin between the minimum to middle of the pay range
Focused on HMSA's Government Programs plans (Medicare, Medicaid, ACA), extracts data from multiple internal and external sources, provides statistical, financial, and business research and analysis to help HMSA manage the MA, QI, and ACA lines of business financial revenue performance. Responsible for analysis and research that ensures the long-term business objective and goals are met within the Medicare Programs Finance department.
Functions independently and serve as a subject matter expert for HMSA's Government Program Finance. Executes projects and represents the department on organizational projects.
| Location | Honolulu, HI |
| Salary | $59,000–$116,000 Per Year |
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