Description
Responsibilities
The Healthcare Finance (HCF) department exists to monitor and improve the financial performance of Kelsey-Seybold's (KS) product lines and health plans. The HCF Analytics team is a customer service-focused department providing consultation to the KS executive team as well as to select operational and functional departments. The HCF Analytics team works closely with internal and external partners to identify revenue and cost savings opportunities, support new product and business development, ensure regulatory compliance, inform contract negotiations and complete reconciliation of incentive arrangements, claims, capitation, and premium payments with other payers, vendors and/or government entities.
The HCF department is adequately staffed by highly skilled, motivated and inquisitive individuals that deliver complex analysis of financial and utilization data to support revenue enhancement and identify cost savings opportunities. The Supervisor will oversee the work of a team of 1-3 analysts and closely collaborate with the Manager and Director of Healthcare Finance to oversee and provide financial data, reporting and other actionable information to the HCF Management Team and other departments regarding relevant business units, process, products and/or service lines. The Supervisor is responsible for ensuring timely receipt and load of external data required for the team?s analysis and reporting. Responsibilities related to this position include:
Oversight and production of recurring financial reports, financial reconciliations, and analysis required to understand the key drivers of the relevant business unit or service line.
Helping to develop and implement the systems and processes that are the foundation for reporting and analysis.
Coordinating the delivery of analytical support to internal customers including the Central Business Office, Pharmacy Services, Business Planning, Accounting, Managed Care Contracting, Claims, Marketing, and Utilization Management departments and partnering with the Business Intelligence team to automate and improve reporting.
Presenting findings and recommending solutions to internal and external customers and KS Executive team.
Providing subject matter and technical guidance to analysts.
Job Title: Supervisor, Healthcare Informatics
Location: Pearland Administrative Office
Department: KS Plan Advantage-Risk Adjustm
Job Type: Full Time
Salary Range: $99,164 - $122,501 (Pay is based on several factors including but not limited to education, work experience, certifications, etc.)
Qualifications
Education
Required: Bachelor?s Degree in Finance, Economics, Mathematics, Healthcare Administration, or related field
Preferred: MBA or MHA preferred
Experience
Required: 5+ years of experience in data analysis, decision support, medical economics, healthcare
informatics, or managed healthcare.
2 + years of experience supervising or managing teams and/or projects.
Demonstrated initiative and problem-solving skills.
Demonstrated ability to create and implement analysis/modeling that converts raw data into actionable
business insights.
Demonstrated ability to analyze and report on business units, products or service lines with minimal
supervision/direction.
Preferred: Experience in the healthcare industry and familiarity with healthcare systems (e.g.,
enrollment/eligibility, capitation, claims payment, etc.) with a Managed Care Organization (MCO)
Knowledge of medical insurance products and basic underwriting concepts.
Experience with Medicare Part C or Health Insurance Marketplaces highly desirable, particularly with CMS risk
adjustment models.
Experience in the healthcare industry with understanding of data in healthcare organizations (including claims
data, ANSI 5010 837 data specifications, ICD10, Medicare Advantage, Health Insurance Marketplace, capitated
payment models).
License(s)
Required: N/A
Preferred: N/A
Special Skills
Required: Advanced proficiency in Microsoft Excel
Basic knowledge of Microsoft Power Point and Microsoft Word
3+ years of programming experience in SQL, SAS or similar application language
Experience writing, debugging and documenting complex queries against relational databases
Experience participating in/leading system design and implementation initiatives
Preferred: Experience with Statistical Software (including SAS, R, Minitab, SPSS)
Experience with reporting tools (including Crystal Reports and Microsoft Access)
Familiarity with EPIC and Clarity reporting data warehouse
Other
Required: Fluent in English both verbal and written, effective communicator
High level of accuracy with excellent attention detail
Strong organizational and time management skills
Proven ability to work in a dynamic setting and balance multiple priorities while meeting deadlines
Superior analytical skills
Ability to communicate complex information in a clear and concise manner
Ability to motivate others and function as a working manager
Preferred: N/A
Working Environment: Office
About Us
Start your career journey and become a part of a community of renowned Healthcare professionals. Kelsey-Seybold Clinic is Houston?s fastest growing, multispecialty organization with more than 40 premier locations and over 65 specialties. Our clinics are comprised of more than 600 physicians and as we continue to grow, our focus is providing quality patient care by adding to our team of clinical and non-clinical professionals that work together in a convenient, coordinated, and collaborative manner. Enjoy the rewards of a successful career while maintaining a work/life balance by joining our team today and changing the way health cares.
Why Kelsey-Seybold Clinic?
- Medical, Vision, and Dental
- Tuition Reimbursement
- Company Matching 401K
- Employee Reward and Recognition Program
- Paid time off for vacation, sick, and holidays
- Employee Assistance Program
- Continuing Medical Education allowance
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