Sr. Analyst, FP&A

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

Position Summary

This role will function as key collaborator with the Sr Manager, plan CFO and other departments in the local market in order to achieve plan financial results. This employee will ensure that all financial reporting, internal or external, are accurately reported and maintain financial and operational control of the business. Collaborate with constituent areas including Actuarial, Network, Central Accounting, Finance Central Reporting and Informatics for analysis purposes on financials and strategic business opportunities proposed throughout the plan.

 

Responsibilities

1.        Prepare all OP, home health, CCSHCN and organ acquisition settlements on an annual basis (approximately 75 settlements).  This requires oversight of the monthly paid claims listing submissions to the state, obtaining the annual cost report from each entity, preparing the calculations for review by the plan finance leadership, distributing to each entity for review, obtaining sign off from each entity once the calculations are agreed upon,  distribution of payment to each entity and once payment is received or paid, ensuring the claims are marked as settled in QNXT (with attribute, the claim cannot be adjusted further).  Above description accounts for a smooth settlement calculation, not any issues that might need to be resolved along the way.

2.        Collaborate with Finance Central Reporting on Medicaid Finance state reporting requirements, including but not limited to: reporting used by the state for lock in program evaluation, capitation payments and RFI adhoc requests. The state reporting requirements are outlined per our contract with the state.  This requires an understanding of the state report and the ability to analyze the data for accuracy prior to submission.

3.        Finance contributions to monthly reserves or other analytic reporting – reconciliation of invoices/claims paid to data housed in plan audit tables

4.        Prepare all off lag accrual inputs for the Central Accounting team (P4Q, shared savings, capitation, settlements (OP, home health, CCSHCN, organ acquisition, vision risk corridor, etc).  Once the financial statements are complete, prepare the off lag information needed for restatement analysis and ensure it ties out once prepared by Finance Central Reporting.

5.        Monthly premium reconciliation – prepare the reconciliation for sign off; review the detail records to determine what needs enrollment updates, requires discussion with the state for potential system changes or needs further research by the plan Finance team to determine next steps. Overall, ensure all premium dollars are received as anticipated.

6.        Prepare the monthly lock in payments for network providers, as applicable.

7.        Prepare quarterly NAIC benchmark reporting (comparison to competitors)

Education

Bachelor Degree

Other License(s): CPA

Prior Relevant Work Experience

3 to 5 years 

Essential Qualifications, Essential Functions & Preferred Qualifications

• The Americans with Disabilities Act (ADA) was designed to provide equal employment opportunities for qualified individuals with disabilities.  The ADA not only prohibits discrimination against qualified applicants and colleagues on the basis of a disability, but also requires employers to provide reasonable accommodations which will enable a qualified individual with a disability to perform the essential functions of the position that person holds or seeks.

•  In order to ensure compliance with the ADA, CVS Health’s job descriptions should identify the essential functions of the position.  These job descriptions can then be used for recruitment and selection, and to help determine reasonable accommodations and return to work arrangements. 

• Essential job functions are the fundamental duties of a position.  A colleague must be able to perform these job functions in order to meet the requirements of the