• Job Description

  Req#: 12021

  Salary Range: $88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00 (Max.)

  Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time.
  
  Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.
  

  Job Summary

  The Reporting Financial Analyst III is responsible for management and preparation of all month-end financial activity reports. This position reviews and provides detailed explanation of variance report to support trend analysis on Revenue, Capitation, Shared Risk, Pharmacy and claims. This position provides ad hoc analysis to support operational requests as they relate to the product lines and/or implemented pilots, contracts with Participating Physician Groups (PPGs), hospitals and ancillary providers. This position works with Financial Compliance on rate setting, PPG audits and Internal/External audits. This position works very close with other departments to coordinate reporting requests and ensure a complete understanding of variances are documented. This position works with the Revenue unit to validate the Medicare HCC scores. Acts as a Subject Matter Expert, serves as a resource and mentor for other staff.

  Duties

  Develops and maintains assigned databases, reports, reconciliations in Excel, Access and SQL SSRS and SSIS for internal and external consumption.

  Assists management with reports, reconciliations, and monthly closings.

  Provides ad hoc analysis to support operational requests as they relate to the L.A. Care's LOBs, claims, contracts with Participating Physician Groups (PPGs), hospitals and ancillary providers.

  Audits and validates data for conversion and import.

  Prepares monthly Department of Health Care Services (DHCS) submissions and assists with all other state or federal submissions and audits.

  Develops, interprets, and implements financial concepts for financial reporting and control.

  Applies subject expertise in evaluating business operations and processes. Identifies areas where technical solutions would improve business performance. Consults across business operations, providing mentorship, and contributing specialized knowledge. Ensures that the facts and details are correct so that the project’s/program's deliverable meets the needs of the department, organization and legislation's policies, standards, and best practices. Provides training, recommends process improvements, and mentors junior level staff, department interns, etc. as needed.

  Perform other duties as assigned.

  Duties Continued

  Education Required

  Bachelor's Degree in Finance or Related Field

  In lieu of degree, equivalent education and/or experience may be considered.

  Education Preferred

  Master's Degree in Finance or Related Field

  Experience

  Required:
  At least 5 years of finance or managed healthcare experience with the demonstrated experience on the following list of stated knowledge, experience and/ or skills.

  Preferred:
  Experience with MHC, Trizetto, BI360.

  Skills

  Required:

  Strong accounting, analytical, and problem-solving skills.

  Excellent oral and written communication skills.

  Excellent data management/ database skills.

  Must have advanced PC Skills (Excel, Word, Access) ASP, and SQL or Monarch.

  Must be familiar with claim CPT/ICD 10 codes.

  Strong Health Care industry knowledge.

  Preferred:
  Medi-Cal and Medicare knowledge.

  QNXT application knowledge.

  Licenses/Certifications Required

  Licenses/Certifications Preferred

  Certified Public Accountant (CPA)

  Required Training

  Physical Requirements

  Light

  Additional Information

  Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change.

  L.A. Care offers a wide range of benefits including

  • Paid Time Off (PTO)
  • Tuition Reimbursement
  • Retirement Plans
  • Medical, Dental and Vision
  • Wellness Program
  • Volunteer Time Off (VTO)

• About the company

  The Local Initiative Health Authority for Los Angeles County, doing business as LA Care Health Plan, is an independent, local public agency based in Los Angeles, California, that began operations as a licensed health plan in 1997.

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