Salary Range: $88,854.00 (Min.) - $108,587.00 (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 in five health plans, we make sure our members get the right care at the right place at the right time.
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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 Financial Analyst III is responsible for preparation and analysis of multiple providers Shared Risk budget amount calculation, claims analysis, journal entry preparation, account analysis, month-end reconciliations and preparation of financial reporting tools for contracted Participating Provider Groups(PPG) for assigned lines of business. Interfaces and serves as liaison with multiple departments and communicates with contracted PPGs as necessary to answer/Resolve Provider Concerns.
Duties
Responsible for preparation and analysis of multiple providers shared risk agreements, calculation of shared risk budget amount, and annual shared risk settlement payments. Prepare accurate and timely analysis and reports for the contracted PPGs. Adjustments made within specified time limits outlined in regulatory SB260 guidelines.
Responsible for the auditing functions needed to produce a reconciled, Shared Risk analysis. Involves monitoring claims activity, DFOR review, reconciling Shared Risk contributions and providing monthly statements and annual settlement statements. Ensure receivables are netted according to contractual arrangements.
Prepare Journal Entries and perform related General Ledger Account analysis and reconciliation of both Shared Risk, Incentives and capitation databases.
Generate monthly financial reporting tools for Shared Risk expense and medical costs for assigned line of business.
Prepare and participate in the completion of all assigned and ad-hoc projects.
Responsible for proper data management.
Perform other duties as assigned.
Duties Continued
Education Required
Education Preferred
Experience
Required:
At least 5 years of experience in a healthcare setting (HMO and IPA), extensive knowledge of capitation and/or shared risk and demonstrated ability to work with complex databases.
Experience in reconciling risk pools, claims experience and understanding DOFR.
Preferred:
At least 2 years of experience in a healthcare setting (HMO and IPA), extensive knowledge of capitation and/or shared risk and demonstrated ability to work with complex databases.
Skills
Required:
Strong accounting, analytical, and problem-solving skills.
Excellent communication skills, oral and written.
Excellent data management/ database skills.
Must have advanced PC Skills (Excel, Word, Access) ASP, and SQL or Monarch.
Preferred:
Medi-Cal, Medicare knowledge.
QNXT application knowledge.
Licenses/Certifications Required
Licenses/Certifications Preferred
Required Training
Physical Requirements
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
- Medical, Dental and Vision
- Wellness Program
- Paid Sick Leave
