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Job description
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.
Performs all other miscellaneous responsibilities and duties as assigned or directed.
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Who can apply
Review the original listing for work authorization, qualifications and employer requirements.