Senior Revenue Analytics & Compliance Analyst

hmsacareers; Honolulu (HI); Hybrid; USD 95,000 - 125,000; Full time

Job summary

HMSA Careers in Hawaii seeks a seasoned Revenue Planning Analyst to analyze and forecast premium revenue, risk adjustment payments, and related income streams across lines of business with minimal guidance. You will interpret financial and enrollment data from internal and external sources to spot opportunities and problems.

The role collaborates with actuarial, finance, compliance and operations to ensure accurate revenue recognition and reporting, develops financial models, performs variance

Qualifications

• Bachelor’s degree with five years of related experience or equivalent.
• Strong presentation skills to peers, management and executive staff.
• Working knowledge of Medicare Advantage, Medicaid, and ACA revenue cycles.
• Strong knowledge of health plan financial data and health industry structure.
• Advanced Microsoft Office skills (Word, Excel, Outlook, PowerPoint).

Responsibilities

• Analyzes and forecasts premium revenue, risk adjustment payments, and other revenue streams related to lines of business with minimal guidance.
• Interprets financial and enrollment data from internal and external sources, identifying opportunities and problems compared to anticipated outcomes.
• Evaluates financial data needs and identifies and implements solutions for program driving accurate coding and documentation to optimize revenue.
• Develops 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, providing actionable insights to leadership.
• Collaborates with actuarial, finance, compliance and operations teams to ensure accurate revenue recognition and reporting.

Skills

Presentation skills

Medicare knowledge

Payer revenue cycles knowledge

Analytical thinking

Education

Bachelor's degree

Tools

Microsoft Office

Job description

HMSA Careers in Hawaii seeks a seasoned Revenue Planning Analyst to analyze and forecast premium revenue, risk adjustment payments, and related income streams across lines of business with minimal guidance. You will interpret financial and enrollment data from internal and external sources to spot opportunities and problems.

The role collaborates with actuarial, finance, compliance and operations to ensure accurate revenue recognition and reporting, develops financial models, performs variance