Overview
This position assesses incoming data from risk adjustment (RA) vendors and calculates financial penalties based on contractual performance. The role also supports contract negotiations through cost analysis, ROI estimation, and budget forecasting, including credit/reimbursement true up analyses at the finalization of vendor projects.
Responsibilities
- Develop new approaches and improvements to validate, collect, and organize vendor data using Visual Basic for Applications (VBA).
- Provide complete and accurate information for vendor audits (e.g., Vendor Delegation Oversight).
- Respond to ad-hoc requests from business stakeholders.
- Serve as a subject matter expert on vendor analytics, including:
- Cost, quantity, and services
- Contract terms, timelines, deliverables
- Performance, including SLA & penalties
- Review and validate invoice submissions to ensure alignment with contractual agreements.
- Assess the quality, timeliness, and completion of incoming risk adjustment vendor data, and calculate financial penalties based on contractual performance.
- Support vendor contract negotiations through cost analysis, ROI estimation, and budget forecasting.
- Assist with contract negotiation by analyzing contractual requirements, identifying contract deficiencies, and recommending changes.
- Provide detailed analysis for PO requests and/or addendums.
- Perform credit/reimbursement true up analyses at finalization of vendor projects.
Requirements
- High School Diploma/GED required.
- Bachelor’s degree in Accounting, Finance, Mathematics, Statistics, Economics, Actuarial Science, or another analytical field preferred; relevant experience may be accepted in lieu of a degree.
- Minimum 4 years’ experience in accounting.
Additional licensing, certifications, registrations
Knowledge
- Knowledge of accounting entries/accruals/month-end close process.
Skills and Abilities
- Experience working in Excel.
- VBA programming experience is a plus.
- Experience with Enterprise Resource Planning (ERP) systems (Workday) is a plus.
- Experience with Billing/Purchasing/Procurement is a plus.
- Medicare, Medicaid, or commercial risk adjustment experience is a plus.
- Programming in SAS/SQL is a plus.
Preferred Qualifications
- Bachelor’s degree in an analytical field
- CPA
- Experience with Workday (ERP)
- SAS/SQL programming
- Risk adjustment experience (Medicare/Medicaid/commercial)
Compensation & Benefits
- Salary Range: $70,500 - $94,395
- Comprehensive health benefits (Medical/Dental/Vision)
- Retirement Plans
- Generous PTO
- Incentive Plans
- Wellness Programs
- Paid Volunteer Time Off
- Tuition Reimbursement
Location
Horizon employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware.