Senior Financial Analyst - Redwood Coast PACE

JOB SUMMARY:

The Senior Financial Analyst supports the financial operations, regulatory reporting, and analytical functions of the Redwood Coast PACE program. Under the direction of the Director of Finance, this role is responsible for financial forecasting, operational analysis, healthcare claims oversight, regulatory reporting, budgeting support, and strategic financial planning activities that support organizational sustainability and compliance.

This position works collaboratively with executive leadership, operational teams, third-party vendors, and regulatory agencies to provide data-driven insights and ensure the effective financial management of the PACE program.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

Prepare and analyze financial, operational, and utilization reports for executive leadership and program management.

Support financial planning activities including budgeting, forecasting, trend analysis, and long-range financial modeling.

Conduct financial and operational analysis related to PACE program initiatives, reimbursement, and performance improvement opportunities.

Coordinate and support CMS, DHCS, and HPMS reporting requirements, including Part D reconciliations and DIR reporting.

Manage and coordinate the annual Milliman Part D Bid process and DHCS annual rate development submissions.

Prepare quarterly financial reports, forecasts, and other required regulatory filings.

Oversee enrollment and disenrollment financial processes including enrollment files, payment reconciliation, and premium tracking.

Serve as the internal lead for claims management activities in collaboration with the Third-Party Administrator.

Support management of pharmacy benefit manager financial operations including invoice review, payment processing, coding, and reconciliation activities.

Prepare and distribute monthly benchmarking and KPI reporting to leadership and operational teams.

Participate in industry and regulatory meetings with organizations such as CalPACE and NPA and provide summaries and recommendations to leadership.

Assist with month-end close processes including claims accrual preparation and journal entry support.

Support annual audits and program-specific financial reviews conducted by internal and external auditors.

Collaborate cross-functionally with operational and clinical teams to support program goals and organizational initiatives.

Additional duties may be assigned, as needed, that align with the responsibilities of the position and support the vision, mission, and values of the organization.

EDUCATION &/or

EXPERIENCE:

Bachelor’s degree in Finance, Accounting, Business Administration, Healthcare Administration, or related field. Equivalent combination of education and relevant experience may be considered.

Minimum of 2 to 5 years of experience in financial analysis, accounting, healthcare finance, reimbursement, or operational finance.

Experience working in a regulated environment with responsibility for reporting, reconciliation, analysis, or budgeting.

Intermediate to advanced Microsoft Excel skills, including data analysis and reporting functions.

Preferred Qualifications

Experience with Medicare, Medi-Cal, managed care, or healthcare reimbursement models strongly preferred.

Experience in a healthcare, nonprofit, government-funded, or insurance-related environment preferred.

Familiarity with claims processing, enrollment reconciliation, or healthcare operational reporting preferred.

Experience with CMS, DHCS, HPMS, or other healthcare regulatory reporting systems preferred.

Experience with Electronic Health Record (EHR) systems and accounting software platforms preferred.

Equivalent Experience Consideration Candidates with strong analytical skills and transferable healthcare finance or reimbursement experience who may not meet all preferred qualifications are encouraged to apply.

PRE-SCREENING REQUIREMENTS:

Requires clearance of a DOJ and FBI criminal history background check.

JOB SKILLS/KNOWLEDGE:

Demonstrates advanced decision-making and sound professional judgment in evaluating complex financial, operational, and strategic issues with minimal supervision.

Analyzes and interprets complex data sets to…