Manager, Finance Analytics

Overview

Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience!

 

Under the direction of the Director of Finance Analytics, the Manager of Finance Analytics is responsible for management and oversight of finance activities related to the commercial line of business (i.e.: Covered CA) and government lines of business (i.e.: Medi-Cal and Medicare), such as managing premium billing functions, supporting DHCS’ SDRs and RDT reports, and ensuring proper payments of regulatory directed payment programs (i.e.: Prop 56/Hospital Directed Payments/GEMT).

 

Commitment to Quality: The IEHP Team is committed to incorporate IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation.

Additional Benefits

IEHP is not only committed to healing and inspiring the human spirit of our Members, but we also aim to match our team members with the same energy by providing prime benefits and more.

• Competitive salary
• State of the art fitness center on-site
• Medical Insurance with Dental and Vision
• Life, short-term, and long-term disability options
• Career advancement opportunities and professional development
• Wellness programs that promote a healthy work-life balance
• Flexible Spending Account – Health Care/Childcare
• CalPERS retirement
• 457(b) option with a contribution match
• Paid life insurance for employees
• Pet care insurance

Key Responsibilities

Oversee billing, payment processing, and reconciliation for DHCS supplemental payments and commercial line-of-business revenue streams.

Manage encounter reconciliation and resolution of encounter/premium discrepancies through coordination with internal business partners and providers.

Maintain accurate departmental records and oversee required audits by leadership, internal audit, regulatory, and external entities.

Guide and mentor Finance Analytics and related teams to ensure productivity, compliance, and alignment with departmental policy.

Provide cross-departmental communication and customer support to ensure timely issue resolution and superior service.

Cooperate in developing and interpreting departmental policies, financial procedures, and regulatory requirements.

Lead initiatives to improve operational accuracy, fraud mitigation, financial controls, and efficiency in financial processes.

Ensure compliance with regulatory standards and organizational policies regarding Covered CA, CMS, DHMC, and HIPAA/PHI protections.

Hire, train, and manage support staff, while monitoring and evaluating outcomes. Conduct performance reviews of each Team Member within IEHP guidelines.

Perform any other duties as required to ensure Health Plan operations and department business needs are successful.

Qualifications

Education & Requirement

• Minimum of five (5) years of relevant managed care, premium billing, and/or other related experience.  A minimum of two (2) years in a supervisory capacity. 
• In lieu of supervisory experience, a Master's degree from an accredited institution or CPA License is required.
• Bachelor's degree in Finance, Business Administration, Economics, Health Care Administration, Accounting, or other related fields from an accredited institution required.

Key Qualifications

• Intermediate knowledge of generally accepted accounting principles (GAAP) and the practical application of general accounting theory. Expert knowledge of commercial health plan billing practices.
• Proficiency in Microsoft Office with advanced Excel skills. Excellent problem-solving skills and strong analytical skills.
• Ability to lead a high performing team. High attention to detail. Communicate effectively at all organizational levels both orally and written.

Start your journey towards a thriving future with IEHP and apply TODAY!

Work Model Location

Telecommute (All IEHP positions approved for telecommute work locations may periodically be required to report to IEHP’s main campus for mandatory in-person meetings or for other business needs as determined by IEHP leadership)

Pay Range

USD $135,700.00 - USD $179,129.60 /Yr.