FP&A Medical Claims Analyst III

Kforce - Denver, CO

Full-time - Mid Level

Denver, CO

Administrative and Support Services

About the position

The FP&A Medical Claims Analyst III position is a permanent role within a leading healthcare organization focused on enhancing patient care through data-driven decision-making. The analyst will leverage their expertise in financial planning and analysis, particularly in the healthcare sector, to analyze medical claims data, support strategic initiatives, and collaborate with clinical leadership to optimize operational efficiency.

Responsibilities

• Analyze and interpret medical claims data to identify trends, variances, and opportunities for cost savings
• Develop and maintain financial models to forecast medical claims expenses and revenue
• Monitor and report on key performance indicators (KPIs) related to medical claims
• Collaborate with clinical department leadership to drive operational excellence through data analysis, interpretation, and validation
• Maintain and leverage an understanding of healthcare operations and the integrated healthcare model at the clinical level
• Interpret large volumes of complex data (e.g., medical records, financials) to provide detailed operational data for evaluating performance improvement initiatives
• Conduct statistical analyses (i.e., SAS, SQL, etc.) to support data-driven decision-making related to medical claims
• Prepare and present detailed financial reports on medical claims to senior management
• Conduct research and prepare business cases related to medical claims in partnership with department leaders
• Assess and evaluate department operations and workflows to identify opportunities for optimizing efficiencies in medical claims processing
• Apply data modeling concepts to financial scenarios involving medical claims

Requirements

• Bachelor's degree in Finance, Economics, or a related field; MBA is preferred
• Minimum of 5 years of experience in financial planning and analysis, with a focus on medical claims analytics and medical economics
• Proficiency in qualitative financial modeling and data analysis tools (e.g., Excel, SQL, Tableau)
• Strong analytical and problem-solving skills
• Excellent communication and presentation skills
• Ability to work independently and as part of a team in a fast-paced environment
• In-depth knowledge of healthcare industry nuances as it relates to medical claims analysis and cost-savings models

Benefits

• Medical, dental, and vision insurance
• Health Savings Account (HSA)
• Flexible Spending Account (FSA)
• 401(k) plan
• Life insurance
• Disability insurance
• Paid time off for salaried personnel
• Paid sick leave for hourly employees on Service Contract Act projects