County Of Montgomery - Norristown, PA
posted 2 months ago
The Managed Care Solutions (MCS) Financial/Data Analyst Manager plays a crucial role in the financial management of the HealthChoices program. This position operates under the supervision of the MCS Administrator and is responsible for a variety of tasks that ensure the effective management of financial data and compliance with program standards. The primary focus of this role includes analyzing financial data to support budget management, capitation development, and financial reporting, as well as managing the MCS data warehouse. The analyst will prepare and review contractual reporting, monitor financial and data system requirements, and validate data accuracy to meet the needs of members and program requirements. In terms of financial and administration management, the analyst will lead the coordination of MCS contracts, including the Request for Proposal function. They will play a key role in developing and monitoring the Department of Human Services (DHS) Capitation rates and County Budget, providing financial support to program staff, and assisting financial staff with reports and reinvestment reporting. The analyst will also prepare financial reports in the absence of the Accountant and assist in developing provider budgets, rates, and billing practices for new and expanding services. The compliance auditing and monitoring aspect of the role involves overseeing the compliance of MCO Claims Processing, Management Information Systems, and Encounter Data Reporting. The analyst will ensure compliance with program standards and play a key role in the annual independent audit, demonstrating through documentation the financial activities necessary to satisfy financial monitoring standards within the DHS contract. From an analytics perspective, the analyst will lead the analysis of medical claims data to develop Incurred but Not Received claims (IBNRs) and ensure the accuracy of financial reporting. They will be responsible for receiving all program statutory and special DHS reports for analysis, maintenance of the MCS Data Warehouse, and development of various reports for management, including demographic, membership, utilization, financial, performance, and social determinants of health. The analyst will reconcile and analyze financial and program data, identifying necessary resources and technology to provide information to management staff to meet business objectives and establish project priorities.