Revenue Analyst II

HMSA; Honolulu (HI); Hybrid; USD 59,000 - 116,000; Full time

Job summary

HMSA in Hawaii seeks a Government Programs Finance Analyst to analyze and forecast revenue across Medicare, Medicaid, and ACA plans. You will extract data from multiple sources and support finance initiatives to optimize program revenue.

You will collaborate with actuarial, finance, compliance and operations teams to ensure accurate revenue recognition and reporting, while maintaining compliance with internal policies.

Qualifications

• Bachelor's degree and four years of related experience, or an equivalent combination of education and related work experience.
• Strong oral and written communication skills for presenting complex information.
• Working knowledge of the techniques used to present financial or statistical data.
• Working knowledge of claims, health plan financial data, and health industry structure.

Responsibilities

• Reporting, Research & Analysis: Analyzes and forecasts premium revenue, risk adjustment payments, and other revenue streams related to lines of business using prescribed guidelines or policies.
• Gathers, validates, and interprets financial and enrollment data from internal and external sources.
• Supports RAF and financial data needs of program driving accurate coding and documentation to optimize revenue from evaluation and interpretation of the information.
• Runs and maintains financial models to assess the impact of regulatory changes, enrollment trends, and market dynamics on revenue.

Skills

Data analysis

Financial data knowledge

Communication skills

Presentation skills

Education

Bachelor's degree

Tools

Microsoft Office

Job description

• Hybrid Work Environment - Must reside in Hawaii**

Employment Type

Full-time

Exempt or Non-Exempt

Exempt

Job Summary

• Hybrid Work Environment - Must reside in Hawaii**

Pay Range: $59,000 - $116,000

Note: Individuals typically begin between the minimum to middle of the pay range

Focused on HMSA's Government Programs plans (Medicare, Medicaid, ACA), extracts data from multiple internal and external sources, provides statistical, financial, and business research and analysis to help HMSA manage the MA, QI, and ACA lines of business financial revenue performance. Responsible for analysis and research that ensures the long‑term business objective and goals are met within the Medicare Programs Finance department.

Functions independently and serve as a subject matter expert for HMSA's Government Program Finance. Executes projects and represents the department on organizational projects.

Minimum Qualifications

• Bachelor's degree and four years of related experience; or an equivalent combination of education and related work experience.
• Strong oral and written communication skills for presenting complex information.
• Working knowledge of the techniques used to present financial or statistical data.
• Working knowledge of claims, health plan financial data, and health industry structure.
• Intermediate working knowledge of Microsoft Office applications, including but not limited to Word, Excel, Outlook, and PowerPoint.

Duties And Responsibilities

• Reporting, Research & Analysis
  • Analyzes and forecasts premium revenue, risk adjustment payments, and other revenue streams related to lines of business using prescribed guidelines or policies.
  • Gathers, validates, and interprets financial and enrollment data from internal and external sources.
  • Supports RAF and financial data needs of program driving accurate coding and documentation to optimize revenue from evaluation and interpretation of the information.
  • Runs and maintains financial models to assess the impact of regulatory changes, enrollment trends, and market dynamics on revenue.
  • Variance analysis: identify and explain variances between actual and projected revenue.
  • Collaborates with actuarial, finance, compliance and operations teams to ensure accurate revenue recognition and reporting.
• Compliance & Documentation
  • Ensure all revenue analysis and reporting adhere to internal policies and regulatory guidelines.
  • Develops and maintains appropriate documentation of desktop procedures for reconciliation and audit needs.
  • Maintains working level knowledge of revenue structures and regulations.
• Leadership & Continuous Improvement
  • Identify gaps and assist in implementing process enhancements to improve the accuracy and efficiency of revenue analysis. Provide informal guidance to new team members.
• Performs all other miscellaneous responsibilities and duties as assigned or directed.