Financial Analyst II (Decision Support)

CalOptima; Orange (CA); On-site; USD 85,000 - 110,000; Full time

Benefits offered by this job

Partial Telework allowed

Job summary

CalOptima seeks a Financial Analyst II (Decision Support) to develop models forecasting medical costs and enrollment, and to assist with contract negotiations and budgeting.

You will leverage Excel, SQL, Access and Tableau to deliver data-driven insights and collaborate with the Data Warehouse team in a fast-paced health plan environment.

Qualifications

• Bachelor's degree in business, finance or related field with 2+ years in medical group/health plan.
• Experience in managed health care or health insurance programs is required.
• Strong analytical and communication skills with ability to work independently.

Responsibilities

• Develop financial models to forecast medical cost trends and enrollment.
• Support provider contract negotiations and actuarial rate studies.
• Assist in annual budgeting processes and ad-hoc analyses as needed.
• Collaborate with Data Warehouse and utilize Excel, SQL, Access, Tableau.

Skills

Excel

SQL

Tableau

Access

Financial modeling

Education

Bachelor's degree in business administration, finance, economics, actuarial sciences or related field

Tools

SQL Server

Tableau Server

Job description

Financial Analyst II (Decision Support)

CalOptima

Join Us in this Amazing Opportunity

The Team You'll Join

We are a mission driven community-based organization that serves member health with excellence and dignity, respecting the value and needs of each person. If you are ready to advance your career while making a difference, we encourage you to review and apply today and help us build healthier communities for all.

More About the Opportunity

We are hoping you will join us as a Financial Analyst II (Decision Support) and help shape the future of healthcare where you'll be an integral part of our Financial Analysis team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders. This position has been approved to be Partial Telework.

• If telework is approved, you are required to work within the State of California only and if Partial Telework, also come in to the Main Office in Orange, CA, at least two (2) days per week minimum.

The Financial Analyst II (Decision Support) will be responsible for providing quantitative financial analysis for various departments within CalOptima Health. Under general supervision, you will develop financial models used to forecast medical cost trends, provide support for provider contract negotiations, assess actuarial rate development studies, participate in annual budgeting functions and provide ad-hoc analytic support as needed. Together, we are building a stronger, more equitable health system.

Your Contributions To the Team

• 90% - Financial Functions
• Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.
• Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department.
• Researches, assesses and develops advanced tools, models, reports and approaches to increase accuracy and timeliness of data-driven work projects.
• Develops medical expense, revenue and enrollment projections to support the budget process.
• Develops financial models and reports to support provider contract negotiations.
• Develops return on investment and business case analyses for program initiatives under consideration by senior management.
• Provides clinical and utilization analyses to assist Medical Management with improving outcomes and quality of care for CalOptima Health members.
• Collaborates with the Data Warehouse team to design and recommend improvements to the data warehouse.
• Utilizes various software (Excel, SQL, Access, Tableau) as appropriate.
• 10% - Other
• Completes other projects and duties as assigned.

Do You Have What the Role Requires?

• Bachelor's degree in business administration, finance, economics, actuarial sciences or related field PLUS 2 years of experience in a medical group, hospital or health plan setting required; an equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying.
• Experience with managed health care or health insurance programs required.

You’ll Stand Out More If You Possess the Following

• Experienced user of Tableau and/or Microsoft SQL Server.

What the Regulatory Agencies Need You to Possess?

• N/A

Your Knowledge & Abilities to Bring to this Role

• Develop rapport and establish and maintain effective working relationships with CalOptima Health's leadership and staff and external contacts at all levels and with diverse backgrounds.
• Work independently and exercise sound judgment.
• Communicate clearly and concisely, both orally and in writing.
• Work a flexible schedule; available to participate in evening and weekend events.
• Organize, be analytical, problem-solve and possess project management skills.
• Work in a fast-paced environment and in an efficient manner.
• Manage multiple projects and identify opportunities for internal and external collaboration.
• Motivate and lead multi-program teams and external committees/coalitions.