Senior Revenue Analyst

Employment Type

Full-time

Exempt

• Hybrid Work Environment - Must reside in Hawaii**

$78,000 - $153,000

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 designing and leading analysis and research that creates the insights needed to ensure the long-term business objective and goals are met within the Medicare Programs Finance department.

Functions independently and serve as a senior level subject matter expert for HMSA's Government Program Finance. Leads projects and represents the department on organizational projects.

• Bachelor's degree and five years of related experience; or an equivalent combination of education and related work experience.
• Strong presentation skills to peers, management and executive staff.
• Working knowledge of Medicare Advantage, Medicaid, and/or ACA revenue cycles for payers.
• Strong Working knowledge of claims, health plan financial data, and health industry structure.
• Advanced knowledge of Microsoft Office applications, including but not limited to Word, Excel, Outlook, and PowerPoint.

• Reporting, Research & Analysis
  • Analyzes and forecasts premium revenue, risk adjustment payments, and other revenue streams related to lines of business with minimal guidance.
  • Interprets financial and enrollment data from internal and external sources, identifying opportunities and problems compared to anticipated outcomes.
  • Evaluates financial data needs and identifies and implements solutions for program driving accurate coding and documentation to optimize revenue.
  • Develops 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, providing actionable insights to leadership.
  • 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, and recommends strategic alternatives.
  • Develops, maintains, and analyzes appropriate documentation of desktop procedures for reconciliation and audit needs.
  • Builds and maintains in-depth knowledge of revenue structures and regulations and conceptual knowledge of related activities.
• Leadership & Continuous Improvement
  • Recommends and implements process enhancements to improve the accuracy and efficiency of revenue analysis.
  • Mentors junior analysts and may be assigned project lead requiring some resource planning assignments.
• Performs all other miscellaneous responsibilities and duties as assigned or directed.