Job Description

Job Title: Finance Analyst IV
Job Location: Georgia


  • Compile and analyze financial information for the company
  • Lead various financial projects
  • Cost effectively manage the utilization of services and develop measures to track, trend and forecast related impacts of organizational strategic initiatives
  • Review monthly performance and financial results of the business unit and provide recommendations to senior management
  • Analyze and interpret claims, premium, membership, and capitation to support management decision making
  • Conduct financial impact analysis for provider contracts and support business negotiations
  • Analyze claims to identify revenue maximization opportunities and prepare operational and risk reports for assigned function management review
  • Review rate setting activity with senior leadership and coordinate implementation plan with corporate and state
  • Responsible for identifying medical cost trends and leadership of medical cost improvement initiatives
  • Lead risk adjustment projects to completion by contributing to database creation, statistical modeling, and financial reports
  • Plan, direct, and coordinate risk and insurance programs of establishments to control risks and losses

Required Qualifications:

  • Strong financial and commercial acumen
  • Bachelor's degree in related field or equivalent experience
  • Six+ years of experience in commercial insurance and Medicare healthcare finance specifically in the area of financial planning/forecasting and budgeting, claims and data analysis, and revenue maximization experience
  • Advanced knowledge of Microsoft Applications (including Excel and Access)

Preferred Qualifications:

  • Experience in claims and knowledge of risk adjusted revenue, member quality and provider reimbursement methodologies
  • Knowledge of managed care information or claims payment systems
  • Product Management and SQL experience
  • Project management experience and financial engineering

QBH#: 2319

Application Instructions

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