Senior Financial Health Data Analyst II

HMSA; Honolulu (HI); On-site; USD 70,000 - 90,000; Full time

Job summary

HMSA in Hawaii is seeking a skilled data analyst to design, develop and implement standard financial and operational reports for providers and plans, responding to customer requirements and business needs. The role emphasizes data accuracy, internal controls and documenting methodologies for audits.

You will interpret data for senior management, participate in project workgroups, share findings, and help monitor reimbursement strategies while tracking cost and utilization.

Responsibilities

• Design, develop and implement standard plan or provider financial and operational reports in response to customer requirements and business needs
• Lead and implement internal controls; facilitate definition of data and other information requirements; define efficient data assembly methods; and maintain adequate documentation for general reference and audit purposes.
• Interpret data and develop reports to communicate findings to senior management.
• Participate in project workgroups; facilitate definition of project requirements and deliverables; influence the progress of team activities and the successful implementation of the project
• Document and share project activities, analyses, and decisions.
• Develop, analyze, recommend, and enhance workflow processes related to project deliverables.
• Evaluates alternative solutions/decision in light of the potential impact on internal/external resources; understand the resource implications of solutions and makes other recommendations; communicate status and recommendations to management.
• Gather data post-implementation to measure outcomes and impacts.
• Develop, analyze, recommend, and monitor reimbursement and provider strategies; prepare reports that measure the effectiveness of reimbursement and contracting terms and the influence they may have on overall program/plan cost and utilization
• Analyze data and identify trends, patterns, or other notable issues with an eye for cost reduction opportunities.
• Monitor market trends to identify emerging opportunities or risks in business environments.
• Monitor various websites for reimbursement and policy changes, focusing on Government entities; make recommendations for implementation of changes.
• Communicate with various stakeholders, including physicians, hospital admin staff, other healthcare insurers, auditors, and other departments within the company.
• Annual review of compliance workflows, such as, SSAE, MAR
• Actively participate in current audits; be able to respond comprehensively to auditor inquiries.
• Review provider contracts and ensure that claims system set ups accurately reflect fully executed, signed agreements.
• Respond to ad-hoc data requests from management, executive staff, and external departments.
• Performs all other miscellaneous responsibilities and duties as assigned or directed.

Job description

Responsibilities

1. Design, develop and implement standard plan or provider financial and operational reports in response to customer requirements and business needs
   • Lead and implement internal controls; facilitate definition of data and other information requirements; define efficient data assembly methods; and maintain adequate documentation for general reference and audit purposes.
   • Interpret data and develop reports to communicate findings to senior management.
2. Participate in project workgroups; facilitate definition of project requirements and deliverables; influence the progress of team activities and the successful implementation of the project
   • Document and share project activities, analyses, and decisions.
   • Develop, analyze, recommend, and enhance workflow processes related to project deliverables.
   • Evaluates alternative solutions/decision in light of the potential impact on internal/external resources; understand the resource implications of solutions and makes other recommendations; communicate status and recommendations to management.
   • Gather data post-implementation to measure outcomes and impacts.
3. Develop, analyze, recommend, and monitor reimbursement and provider strategies; prepare reports that measure the effectiveness of reimbursement and contracting terms and the influence they may have on overall program/plan cost and utilization
   • Analyze data and identify trends, patterns, or other notable issues with an eye for cost reduction opportunities.
   • Monitor market trends to identify emerging opportunities or risks in business environments.
   • Monitor various websites for reimbursement and policy changes, focusing on Government entities; make recommendations for implementation of changes.
   • Communicate with various stakeholders, including physicians, hospital admin staff, other healthcare insurers, auditors, and other departments within the company.
4. Annual review of compliance workflows, such as, SSAE, MAR
   • Actively participate in current audits; be able to respond comprehensively to auditor inquiries.
   • Review provider contracts and ensure that claims system set ups accurately reflect fully executed, signed agreements.
5. Respond to ad-hoc data requests from management, executive staff, and external departments.
6. Performs all other miscellaneous responsibilities and duties as assigned or directed.