Financial Analyst

SHPCA SCAN Health Plan; City of Long Beach (NY); Hybrid; USD 60,000 - 93,000; Full time

Benefits offered by this job

Remote work

Annual bonus program

Wellness program

Paid time off

Paid holidays + birthday

401(k) employer match

Employee recognition program

Tuition reimbursement

Community impact

Job summary

SCAN Health Plan is seeking a Financial Analyst to support the management of capitation payments, accruals, and CMS bid data. You will ensure system configuration accuracy, contract interpretation, and data integrity across provider payments.

In this role, you will collaborate with multiple teams to process capitation, maintain the capitation module, and develop process documentation. A degree and 3-5 years of related experience are required, with strong analytical and communication skills.

Qualifications

• Associate's Degree or Technical Degree or equivalent experience.
• 3-5 years of related experience.
• Advanced analytical skills.
• Strong problem solving and communication abilities.
• Proficiency with Microsoft Office Suite (advanced).

Responsibilities

• Assist the manager in capitation payment processing and data integrity.
• Interpret contracts to ensure system accuracy and compliance.
• Manage databases and ensure provider payments are accurate.
• Ensure CMS bid accuracy and data for accruals and reserves.
• Lead interdepartmental meetings for audits and CMS bids.

Skills

Advanced analytical skills

Problem solving

Communication

Microsoft Office Suite

Education

Associate's Degree

Technical Degree

Tools

Microsoft Office Suite

Job description

Founded in 1977 as the Senior Care Action Network, SCAN began with a simple but radical idea: that older adults deserve to stay healthy and independent. That belief was championed by a group of community activists we still honor today as the '12 Angry Seniors.' Their mission continues to guide everything we do. Today, SCAN is a nonprofit health organization serving more than 500,000 people across Arizona, California, Nevada, New Mexico, Texas, and Washington, with over $8 billion in annual revenue. With nearly five decades of experience, we have built a distinctive, values-driven platform dedicated to improving care for older adults. Our work spans Medicare Advantage, fully integrated care models, primary care, care for the most medically and socially complex populations, and next-generation care delivery models. Across all of this, we are united by a shared commitment: combining compassion with discipline, innovation with stewardship, and growth with integrity. At SCAN, we believe scale should strengthen - not dilute - our mission. We are building the future of care for older adults, grounded in purpose, accountability, and respect for the people and communities we serve.

The Job

• The Financial Analyst assists the manager in leading the department to ensure accurate system configuration, capitation payment processing, accruals, shared risk pool calculation, and claims expense recording.
• Interprets contractual agreements to ensure system accuracy and compliance.
• Manages databases and ensures that provider payments are accurate.
• Ensures data integrity for audit and bid process for all entities.
• You Will Facilitates and leads intradepartmental meetings required for audit, accruals, data analysis, annual Center for Medicare and Medicaid Services (CMS) bids, capitation and claims reserves Oversees timely and accurate completion of all shared risk pool settlements on a quarterly and annual basis and provides guidance for the team on technical aspects of contract language Liaison with Network Management, Shared Services, Claims, Legal, Actuary, Compliance and Enrollment to ensure accuracy of provider contract application in the system for explicit capitation calculations and payment On-going testing, validation, monitoring and financial reporting of the capitation module with continued efforts relating to processes improvement, CMS guidelines and system upgrades Responsible for the maintenance and data integrity of the capitation and shared risk modules by managing the configuration, analysis documentation, and testing of the system set-up to support current and future operational needs and compliance requirements Mentors team by providing guidance, support, and assisting with escalated issues and tasks, as needed Assures timely and accurate monthly provider capitation payments Creates system documentation, including process flow and desk top procedures Ensures compliance by evaluating new, proposed, and existing contractual agreements as they relate to payment methodologies for both capitated and shared risk arrangements (Medical Groups, Hospitals, and Ancillary Providers) Timely response and resolution to Network Management inquiries Provides management with planning and control information by assembling and analyzing historical financial data, identifying trends, providing forecasts, explaining processes and techniques, recommending actions and revisions and departmental improvements, as needed Contributes to team effort by accomplishing related results, as needed Ensures CMS bid accuracy by providing detailed and complex capitation and accrual data (member level detail) on a GAAP to incurred basis Collaborates and provides analytical support to the Finance, Network Management, Pharmacy and Health Care Informatics departments by assimilating data from multiple sources into clear meaningful reports in support of specific accruals and reserves for multiple programs and entities Compiles and presents complex capitation information by organizing and explaining data, assumptions and recommendations, as needed.
• Initiates membership and payment audits and ensures efficiency in the capitation process.

Your Qualifications

Associate's Degree or Technical Degree or equivalent experience. 3-5 years of related experience. Performs work under minimal supervision. Handles complex issues and problems, and refers only the most complex issues to higher-level staff. Possesses comprehensive knowledge of subject matter. Provides leadership, coaching, and/or mentoring to a subordinate group but does not directly supervise. Technical expertise - Advanced analytical skills. Problem Solving - Basic problemsolving skills. Communication - Good communicationand interpersonal skills. Microsoft Office Suite at advanced level required.

What's in it for you?

• Base salary range: $60,400 to $92,602 per year
• Work Mode: Mostly Remote
• An annual employee bonus program
• Robust Wellness Program
• Generous paid-time-off (PTO)
• Eleven paid holidays per year, plus 1 floating holiday, plus 1 birthday holiday
• Excellent 401(k) Retirement Saving Plan with employer match and contribution
• Robust employee recognition program
• Tuition reimbursement
• An opportunity to become part of a team that makes a difference to our members and our community every day! We're always looking for talented people to join our team!

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c)

Why consider a career at SCAN?

• A competitive compensation and benefits program;
• An annual employee bonus program;
• Generous paid-time-off (PTO);
• Eleven paid holidays per year;
• Excellent Retirement Savings program;
• A work-life balance;
• and - An opportunity to become part of a team that makes a difference to our members and our community every day!

If the SCAN mission is one you believe in too, we invite you to explore the career opportunities at SCAN.

At SCAN we believe that it is our business to improve the state of our world. Each of us has a responsibility to drive Equality in our communities and workplaces.

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities.

We are committed to creating a workforce that reflects our community through inclusive programs and initiatives such as equal pay, employee resource groups, inclusive benefits, and more. SCAN is proud to be an Equal Employment Opportunity and affirmative Action workplace. Individuals seeking employment will receive consideration for employment without regard to race, color, national origin, religion, age, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender perception or identity, age, marital status, disability, protected veteran status or any other status protected by law.

A background check is required.