Sr Financial & Data Analyst – Healthcare Economics
Hybrid · Des Moines, Iowa, United States
Job Summary
Lead, design, implement and maintain provider reimbursement strategies, including financial reporting for all Wellmark-contracted providers and multi-year agreements. Mentor team members and serve as the subject matter expert on provider reimbursement; collaborate with Health Network stakeholders on payment policy decisions. Perform advanced data analysis to interpret provider data and provide pricing recommendations. Proficient use of Power BI, Tableau, SAS EG and/or SQL. Must have a Bachelor's degree in Accounting, Finance, Business, Economics or related field and 7+ years of health-insurance experience including reimbursement/contracting; office hybrid schedule in Des Moines with Tue-Thu in-office days and remote option Mon & Fri.
Required Qualifications
- Bachelor's degree in Accounting, Finance, Business, Economics or related field or direct and applicable work experience
- 7+ years of relatable experience within the Health insurance industry including: Demonstrated experience performing financial analysis and data modeling in a healthcare setting
- Solid knowledge of and demonstrated ability in Microsoft Excel (including superior ability in the use of Excel Macros, Advanced Formulas and Pivot Tables)
- Previous experience in a healthcare, finance or related field
- Knowledge of hospital, physician and other provider payment and contracting strategies
- Demonstrated knowledge of the health insurance industry including delivery systems and managed care concepts; thorough understanding of reimbursement, contracting, claims processing, medical policies
- Experience interpreting claims data, trends and provider utilization in order to determine payment strategy or payment strategy results
- Demonstrated forethought of issues before questioned; ability to research, ask questions and find solutions to potential problems
- Demonstrated problem-solving, quantitative and analytical skills; ability to recognize inconsistencies, analyze for reasonableness and accuracy, research and come to conclusions
- Strong analytical skills and proven problem solving ability with a proven record of independent problem identification and resolution skills
- Comprehensive knowledge of nationally recognized provider compensation strategies
- Strong attention to detail in developing and implementing action plans
- Demonstrated ability applying strong analytical, conceptual and strategic thinking skills to negotiate with providers, or the organizations representing them
- An Equal Opportunity Employer
- This position will work a hybrid schedule of at least 3 days in Wellmark's Des Moines office (Tuesday-Thursday), with Monday & Friday remote option
- Wellmark not sponsoring immigration sponsorship for this role currently (F1-OPT, H-1B, TN, L-1, J-1 etc. not eligible)
Additional Requirements
- No immigration sponsorship available now or in the future
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