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Primary Purpose:
Works independently to facilitate all projects, and plans, develops, manages, and directs all activities related to financial reporting, analysis, management, and compliance of HMSA's Medicare and/or Medicaid based products to help meet HMSA's corporate goals and initiatives.

Minimum Requirements:

1. Bachelor's degree and five years related work experience, or equivalent combination of education and related work experience.
2. Proficiency in data reporting and analysis skills.
3. Knowledge of managed care/health care business processes, systems and applications for claims payment, member eligibility and provider information.
4. Proficiency in project management skills.
5. Intermediate working knowledge of Microsoft Office applications including Word, PowerPoint, and Outlook.
6. Advanced working knowledge of Microsoft Excel.
7. Proficiency in MicroStrategy, SQL, SAS, or other query language

1. Facilitates complex projects and functions of high importance as an independent project lead. Plans and manages the project development process and oversees implementation. Analyzes intricate project objectives, data sources, methodology, data summaries and findings, and prepares and edits draft, revised and final reports for dissemination to key project sponsors to meet information request specifications. Coordinates and prioritizes activities with internal and external staff for implementation and monitors work for accuracy. Ensures that outcomes meet HMSA's corporate goals.
2. Proactively develops, implements and/or enhances new data extract methodologies and advanced process improvements to support financial reporting for HMSA's major government programs. Monitors changes in the external/internal environment, evaluate government and other payer system requirements that have significant impact on HMSA's government program revenue. Ensures that reporting methodologies are consistent with the government entities expectations and goals.
3. Performs financial analysis for revenue forecasting, develops comprehensive financial models and cost and/or utilization reports to assist with financial projections, planning and/or negotiation efforts. Provide critical assessments of revenue impacts associated with any payment changes. Identifies financial and/or operational implications due to government mandates.
4. Mentors, manages, provides direction for, monitors, reviews, and provides feedback on project staff's work.
5. Participates and promotes team activities by providing leadership, consultation, managing other projects, sharing accountability and expertise, communicating, and improving integrity of workflows, and providing constructive feedback on other team members' performance.
6. Performs all other miscellaneous responsibilities and duties as assigned or directed.