*There is one position which can be filled remotely in California, Oregon, Washington, Nevada, Utah, Idaho, Arizona, Colorado or in any of our 3 offices (Scotts Valley, Merced or Salinas, California).
*This is a remote opportunity. In order to qualify for this role, you must currently reside in or plan to reside in the locations listed above upon the start this role.
WHAT YOU'LL BE RESPONSIBLE FOR
Reporting to the Provider Payment Director, you will manage and lead the development of data submissions to both the State and local customers and provide insight related to the design and development of reports and modeling utilized by the Alliance in decision making, including automation, timeliness, and reporting accuracy. You will provide management oversight and guidance related to the financial analytics function, act as a subject matter expert, and provide guidance on departmental operations. You will also utilize the Data Mart and SQL to develop financial analysis and reporting, while overseeing the compilation of the Medi-Cal Rate Development Template and submission to the State. You will manage, supervise, mentor and train assigned staff
ABOUT THE TEAM
The Provider Payment team’s focus is improved medical cost and health outcomes for our members. We are truly an analytics team at heart. We are solutions based, critical thinkers with a passion for what we do. We work in a fast-paced, collaborative environment that promotes professional growth and success, embraces challenges, supports accountability and celebrates accomplishments.
THE IDEAL CANDIDATE
You are a skilled, hands-on leader with an analytical mindset. You have a passion for developing teams and supporting professional growth. You approach your work always taking in to account the bigger picture of the organization, and use this approach while developing and improving processes. You have a solid background in healthcare claims, revenue/healthcare finance and project management. You are technically savvy, with strong knowledge of data structures, interpretation, coding, the analytic life cycle, root cause analysis and data warehouse environments. You are highly organized and thrive in a fast-paced environment.
WHAT YOU'LL NEED TO BE SUCCESSFUL
To read the full position description, and list of requirements click here.
- Knowledge of:
- Research, medical cost analysis and reporting methods
- Healthcare industry specific terms and healthcare related data types and structures, including member, claims, clinical and provider data
- Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS)
- Healthcare industry and healthcare information standards such as HL7, LOINC, FHIR, ICD 9/10 and CPT codes, industry standard groupers, such as ETGs, DRGs, and DCGs
- Data modeling techniques, the use of SQL for data mining and analysis, and data visualization tools, such as Tableau
- Quantitative data analysis methodologies and analytical tools related to reporting medical cost analysis
- Ability to:
- Train, mentor, supervise, and evaluate the work of staff, promote an atmosphere of teamwork and cooperation, and motivate staff to achieve goals and objectives
- Organize and prioritize the work of others, delegate effectively, and follow up on work assignments
- Foster effective working relationships, influence others, and build consensus with individuals at all levels in the organization
- Develop data-driven and outcome-based initiatives to improve business decision making and improve business processes
- Demonstrate flexibility and creativity, identify improvements to existing practices, and to effectively adapt to change
- Education and Experience:
- Bachelor’s degree in Computer Science, Accounting or Finance
- A minimum of six years of experience performing financial and cost analysis, including a minimum of two years of experience in a managed care environment, and some lead or supervisory experience; (a Master’s degree may substitute for two years of the required experience); or an equivalent combination of education and experience may be qualifying
- While this position is connected to one of our Alliance offices, we are in a fully telecommute work environment right now due to the COVID-19 pandemic. The interview and on-boarding process for this position will be completed remotely
- This position may require onsite presence when our offices re-open, which will be no sooner than February 1, 2022. Onsite presence will begin on a part-time basis, but is dependent on business need
Additionally, all positions at the Alliance are required to meet these minimum qualifications.
- Medical, Dental and Vision Plans
- Ample Paid Time Off
- 11 Paid Holidays per year
- 401(a) Retirement Plan
- 457 Deferred Compensation Plan
- Robust Health and Wellness Program
- EV Charging Stations
- And many more
We are a group of over 500 dedicated employees, committed to our mission of providing accessible, quality health care that is guided by local innovation. We feel that our work is bigger than ourselves. We leave work each day knowing that we made a difference in the community around us.
Join us at Central California Alliance for Health (the Alliance), where you will be part of a culture that is respectful, diverse, professional and fun, and where you are empowered to do your best work. As a regional non-profit health plan, we serve over 377,000 members in Santa Cruz, Monterey and Merced counties. To learn more about us, click here.
At this time the Alliance does not provide any type of sponsorship. Applicants must be currently authorized to work in the United States on a full-time, ongoing basis without current or future needs for any type of employer supported or provided sponsorship.