Health Care Analyst - Risk and Finance Senior Health Services (REMOTE)

<strong>At Emergent Holdings, we&rsquo;re creating an innovative environment where our employees belong authentically, contribute meaningfully, and thrive intentionally &mdash; both personally and professionally.</strong>

Southfield, USA

Emergent Holdings

<p class="p1"><strong>Emergent Holdings is driven by a singular goal &mdash; improving the health and safety of our customers and our communities. How do we do that? We create innovative insurance products, technology solutions, and services to support our key stakeholders &mdash; individuals, employers, providers, and strategic partners &mdash; improving the health and safety of the people and places we serve.</strong></p>

keywords: job description,support,analysis,performance,verify,other duties,education,experience,skills


Competitive Compensation and Benefits Package

Overview: <br />The Healthcare, Risk, and Financial Analyst is responsible for identifying, collecting, analyzing, and maintaining data to evaluate issues that support prospective business decisions. This role also is responsible for coordinating projects for senior management.<br /><br /><br /> <p><strong>WORKING CONDITIONS:</strong></p> <p>Work is performed in an office setting or remote with no unusual hazards.&nbsp;</p>
Responsibilities: <br /> <ul> <li>Researches, analyzes, identifies, and evaluates data from assigned problems to evaluate existing and potential trends, risks, and issues.</li> <li>Possesses and maintains a comprehensive understanding and knowledge of BCBSM business, products, programs related to Medicare Advantage, corporate organizational structure (including functional responsibilities), and basic research principles/methodologies.</li> <li>Assists in the management and monitoring of multiple projects simultaneously by establishing project plans and objectives to ensure goal attainment within defined parameters.</li> <li>Communicates results of analysis to management via reports/presentations and assists management in implementing programs that provide solutions.</li> <li>Provides expertise and guidance to business unit and corporate staff as required</li> <li>Reviews group rates to analyze impact on margins</li> <li>Represents and participates in group or committee discussions</li> <li>Financial analysis, tracking, forecasting and oversight of budgets</li> <li>Including but not limited to, monitoring cash flow, ensure invoices are approved and paid to external vendors, and support capital planning/future budgets</li> <li>Membership Forecasting and Analysis</li> <li>Tracks programs that are billed as non-claims benefit expense for key accounts, ensuring billing is accurate and groups are informed on upcoming changes and impacts</li> <li>Support the Group MA Sales team with Retention Groups and New Group Sales</li> <li>Coordinate between Underwriting and Actuary in supporting the Renewal Process</li> <li>Produce weekly, quarterly and ad-hoc reporting in a timely manner</li> <li>Support Docusign Reporting and Process Improvement</li> <li>Support P&amp;L Statements and Deliverables</li> <li>CMS Group Employer Reporting and Data Validation Audits</li> <li>Statement of Work contracting with external vendors and coordination with procurement</li> <li>Evaluate proposals and ensure pricing is fair and precise</li> <li>Work with procurement on ensuring timelines of processing contracts are met to stay in compliance</li> <li>Tracks budgets for external vendor contracts, approving invoices and instituting changes orders as needed</li> </ul> <br /> <p>This position description identifies the responsibilities and tasks typically associated with the performance of the position. Other relevant essential functions may be required.</p>
Requirements: <br /> <p><strong>EDUCATION:<br /><br /></strong></p> <ul> <li>Bachelor&rsquo;s degree in Business Administration, Health Care, Finance, or related field.&nbsp;</li> <li>Master&rsquo;s degree in a related field is preferred.&nbsp;</li> <li>Relevant combination of education and experience may be considered in lieu of degree.&nbsp;</li> <li>Continuous learning, as defined by the Company&rsquo;s learning philosophy, is required.&nbsp;</li> <li>Certification or progress toward certification is highly preferred and encouraged.</li> </ul> <br /> <p><strong>EXPERIENCE:<br /><br /></strong></p> <ul> <li>Five years of experience required in a related field with demonstrated knowledge that provides the necessary knowledge, skills, and abilities.&nbsp;</li> <li>Analyst experience with proven expertise in operational analysis, data analysis, and problem resolution type activities is required.</li> </ul> <br /> <p><strong>SKILLS/KNOWLEDGE/ABILITIES (SKA) REQUIRED:<br /><br /></strong></p> <ul> <li>Ability to plan, organize, direct, and control projects.</li> <li>Understanding of basic accounting techniques and principles</li> <li>Understanding of procurement and vendor management topics</li> <li>Ability to lead and contribute to process improvement projects.</li> <li>Strong communication skills with the ability to understand, interpret, and communicate ideas.</li> <li>Strong knowledge and use of existing software packages (PowerPoint, Excel, Word, etc.).</li> <li>Strong analytical, organizational, planning, and problem-solving skills.</li> <li>Ability to effectively interface with employees at all levels.</li> <li>Ability to understand and apply statistical inference.</li> </ul> <br /><br /> <p>The qualifications listed above are intended to represent the minimum education, experience, skills, knowledge, and ability levels associated with performing the duties and responsibilities contained in this job description.&nbsp;</p> <p>We are an Equal Opportunity Employer. Diversity is valued and we will not tolerate discrimination or harassment in any form. Candidates for the position stated above are hired on an "at will" basis. Nothing herein is intended to create a contract.</p>