Duties & Responsibilities:
Provides cost and trend surveillance for all lines of business. Leads the analysis of all designated categories to understand the drivers of cost and utilization increases/decreases, by designated category and provider compared to designated budget.Collaborates with team members to identify, analyze and document the monitoring related costs and vendor oversight, including building and developing monthly and quarterly reports to monitor spend and utilization dashboards. Monitors and organizes all aspects of our vendor contracts with including capitation/admin system configuration. This includes but is not limited to validating invoices, audit support, claims and utilization reports as well as identifying and overseeing any needed areas of recoupment from vendor. Assists the team with monitoring the department budgets and confirming all business-related expensesAdopts best practices in documenting job related processes. Documents policies and procedures, job aids and workflows for the departmentSupports the validation of all department finance related regulatory reporting submitted by Healthfirst to State and Federal agenciesConducts and assists with ad-hoc analyses as needed by the designated team and other Healthfirst departmentsAdditional duties as necessaryMinimum Qualifications:
Bachelor's Degree from an accredited institutionPreferred Qualifications:
Intermediate level of understanding how to use Business Intelligence/reporting tools – Base SAS/SAS EG/Tableau/Aginity Workbench/SQL Server Management StudioIntermediate level of understanding how to use reporting and/or dashboarding as a means to analyze and measure performanceIntermediate skill level with MS Excel/Access/Word/PowerPointExperience working with delegated vendors and performing oversight/monitoring activities within a managed care health plan or Pharmacy Benefits ManagerExcellent time management skills to handle multiple projects and manage shifting prioritiesCompliance & Regulatory Responsibilities: Noted above
License/Certification: N/A
Hiring Range*:
Greater New York City Area (NY, NJ, CT residents): $67,200 - $97,155
All Other Locations (within approved locations): $59,800 - $88,910
As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision.
In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live.
*The hiring range is defined as the lowest and highest salaries that Healthfirst in “good faith” would pay to a new hire, or for a job promotion, or transfer into this role.