Healthcare Financial Analyst

Assess healthcare data sets to measure the costs, impact and value of healthcare programs, then summarize results for financial reporting and subject matter experts (SMEs). By providing high-quality and thoughtful financial data, Healthcare Financial Analysts help internal SMEs make informed decisions about how to measure and manage the care of Health Plan of San Mateo’s (HPSM’s) 140,000-plus members.

Data analysts who want to improve their skills through on-the-job training, make consistent contributions to impactful organizational deliverables and collaborate with a supportive team of experienced Financial Planning & Analysis colleagues would thrive in this position. Those who get energized by investigative puzzle-solving, Excel formula writing/data wrangling, and healthcare data and policy thought partnership would be a perfect fit.

Position overview, pt. I (what you would do most of the time)

• Using healthcare utilization history and cost data, estimate monthly reserves required for incurred but not reported (IBNR) claims and report to management
• Support completion of governmental reporting to the Centers for Medicare and Medicaid Services (CMS) and California’s Department of Health Care Services (DHCS) on healthcare cost expenditures and trends
• Investigate, understand and communicate the drivers of healthcare costs and utilization
• Reconcile data sources, reports and/or provider payments
• Identify and troubleshoot data anomalies
• Provide analytic or data manipulation support to departmental colleagues

Position overview, pt. II (what you would do some of the time)

• Perform inquisitive data analysis of medical cost trends, utilization and provider contracting/ reimbursement at the request of colleagues from Claims, Health Services and Provider Services
• Answer SMEs’ questions by formulating queries, identifying the root causes of problems and offering potential solutions
• Estimate the costs or utilization associated with healthcare benefits or programs and support team colleagues in developing recommendations to the organization

The FP&A team

HPSM’s 17-person Finance Department is split into two units – Accounting and Financial Planning & Analysis (FP&A). FP&A has three teams, and Healthcare Financial Analysts are on the one that’s responsible for financial/utilization analysis and reporting. They report to the Director of FP&A but enjoy the benefit of close support and mentorship from a dedicated team of five other analysts, each with their own subject matter expertise.

Collectively, the team has many years of experience at HPSM and therefore a wealth of institutional knowledge. Everyone on the team continually learns on the job, from each other and by taking outside courses (paid for by HPSM’s tuition reimbursement benefit). FP&A’s collaborative culture means colleagues are actively engaged and invested in helping each other develop professionally and excel at their jobs – because that helps the team and HPSM succeed in improving our members’ lives.  

Requirements

These are the qualifications typically needed to succeed in this position. However, you don’t need to meet every requirement to apply. 

Education and experience

• Bachelor’s degree in a critical-thinking heavy field with demonstrated interest in health care (e.g., public health statistics, medical economics, actuarial sciences, medical anthropology/sociology, etc.)
• Minimum of five years’ experience in government health care data analysis (preferably in a health plan or IPA/medical group environment with a finance focus)   

Knowledge of:

• Complex statistical and financial analysis research techniques
• Medi-Cal (Medicaid) and Medicare data reporting standards, terminology and guidelines
• Data manipulation and analysis tools, including MS Excel (expert to advanced mastery required), SQL and Access; experience with data visualization tools such as PowerPoint or Power BI preferred

Ability to:

• Critically evaluate complex healthcare cost and trend issues using large data sets and your quantitative and qualitative analysis skills
• Prepare and present clear and concise reports that are action or outcomes oriented
• Be a collaborative colleague who contributes to a constructive team dynamic

Salary and benefits

The starting salary range is $83,855-$107,714 per year, depending on the candidate’s work experience.

Excellent benefits package includes:

• HPSM-paid premiums for employee’s medical, dental and vision coverage (employee pays 10% of each dependent’s premiums)
• Fully paid life, AD&D and LTD insurance
• Retirement plan (HPSM contributes equivalent of 10% of annual compensation)
• 12 paid holidays a year, 12 paid sick days a year and paid vacation starting at 16 days a year
• Tuition reimbursement plan
• Employee wellness program

It is HPSM's policy to provide equal employment opportunity for all applicants and employees.  HPSM does not unlawfully discriminate based on race, religion, color, national origin, ancestry, physical disability, mental disability, medical condition, marital status, sex, age, sexual orientation, veteran status, registered domestic partner status, genetic information, gender, gender identity, gender expression, or any other characteristic protected by applicable federal, state, or local law.  HPSM also prohibits discrimination based on the perception that an applicant or employee has any of those characteristics or is associated with a person who has or is perceived to have any of those characteristics.