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Associate Medical Cost Analyst - Miami, FL - Full-time / Part-time
•30 days ago
| Hours | Full-time, Part-time |
|---|---|
| Location | Miami, FL Miami, Florida |
About this job
Position Description:
Primary Responsibilities:
- Performs in-depth medical cost and financial time series and
cross sectional trend analysis. - Write SQL code and analyze in-depth trends such as acute and
non-acute admits / 1,000, days /1,000, ALOS for root causes and make
recommendations. - Must be able to fully audit revenue, capitation payments,
claims detail payments, and identify claims overpayments. - Must be able to audit risk providers contracts loading and
payments for CPT/Revenue/ HCPC codes, Diagnoses, DRGs. - Must be familiar with various reimbursement methods:
Capitation, FFS, DRG, APC, Global risk, episode of care. - Must be familiar with pharmacy, Hedis, Stars, Medicare Risk
scores, and its effects on future revenue. - Develop new reports using SSRS, SQL, MS Access, Excel,
and / or Crystal Reports, Business
Objects, and VBA. - Develop ad-hoc analyses based on complex user requirements
for CEO, COO, Finance VP, Medical Director, Network Management and Utilization
Management Dept. - Be able to explain variances of actual costs and other
statistical measures to budget/forecasts from an actuarial cost volume model,
from financials, and from external sources to Managers, Actuaries, and
accounting CPA's. - Perform financial and medical cost trend analysis for
capitation and global risk provider contracts, accountable care organizations,
episode of care reimbursements and other risk contracting providers. - Responsible for preparation and distribution of various
reports to Manager and various departments on recurring basis. - Performs other finance duties as required or as
requested by the Director of Finance and/or Manager of Analysis.
Requirements
Required Qualifications:
- Bachelor's degree
- Medical/Healthcare industry
experience - Knowledge within finance, economics, or
statistics background - Data
analysis experience - Experience
building reports in SQL - Experience with Transact-SQL for SQL Server
2008/2012 - Experience
MS Excel (v-lookups and pivot tables)
Preferred
Qualifications:
Bachelors Degree, preferably in Finance, Economics,
Statistics or related field.- Microsoft Access experience
- Medical cost analysis experience
Careers at UnitedHealthcare Medicare & Retirement. The Boomer generation is the fastest growing market segment in health care. And we are the largest business in the nation dedicated to serving their unique health and well-being needs. Up for the challenge of a lifetime? Join a team of the best and the brightest to find bold new ways to proactively improve the health and quality of life of these 9 million customers. You'll find a wealth of dynamic opportunities to grow and develop as we work together to heal and strengthen our health care system. Ready? It's time to do your life's best work.SM
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