Senior Financial Analyst

Overview

A growing healthcare organization focused on value-based care is seeking a Senior Financial Analyst to support the financial performance of Medicare Advantage and risk-based healthcare programs. This role primarily supports a key institutional special needs plan (I-SNP) and chronic special needs plan (C-SNP) relationship and affiliated risk-bearing facilities.

Reporting to the Vice President of Finance, the Senior Financial Analyst will deliver timely, decision-oriented financial reporting and partner closely with Strategy, Operations, Clinical, and external stakeholders to drive financial transparency, accountability, and performance improvement.

Responsibilities

Financial Performance Reporting & Analysis

• Prepare and deliver monthly financial performance reports including P&L analysis, utilization trends, healthcare spend analysis, and gainshare/risk-share results.
• Develop clear financial storylines and actionable recommendations for executive leadership and stakeholders.
• Create executive summaries, presentations, dashboards, and ad hoc analyses to support strategic decisions.
• Monitor health plan product and facility performance, identifying trends, risks, and opportunities.

Risk Arrangements, Capitation & Reconciliation

• Manage facility-level risk agreement calculations and performance incentive reporting with accuracy and timeliness.
• Lead monthly capitation and membership reconciliation processes in collaboration with Finance and Operations.
• Investigate variances, identify root causes, and coordinate resolution across stakeholders.
• Support financial transparency and accountability within risk-based reimbursement arrangements.

Claims, Utilization & Healthcare Cost Analysis

• Analyze healthcare claims, medical expenses, utilization patterns, and cost drivers to identify trends and business implications.
• Evaluate and refine accrual methodologies and healthcare cost forecasting.
• Review denied and high-cost claims and payment variances to ensure accuracy and identify recovery opportunities.
• Collaborate with clinical and operational leaders to understand utilization trends and improve financial performance.

Part D Financial Oversight

• Maintain documentation related to Part D funds flow, revenue sources, accrual methodologies, and operational drivers.
• Support leadership discussions on Part D performance, vendor costs, and financial optimization.
• Provide analytical support related to pharmacy performance and healthcare cost trends.

Audit, Regulatory & Vendor Support

• Track recoveries, recoupments, and reimbursement adjustments ensuring accurate accounting.
• Support internal and external audits, preparing financial schedules, documentation, and regulatory submissions.
• Coordinate and analyze vendor data for accounting, reporting, and prefunding activities.
• Assist with CMS-related financial reporting and compliance.

Budgeting, Forecasting & Strategic Support

• Support annual budgeting, forecasting, long-range planning, and cash flow analysis.
• Assist with Medical Loss Ratio (MLR) reporting, Medicare Bid development, and other CMS deliverables.
• Partner with Data Operations and Reporting teams to develop and maintain financial and operational reporting.
• Provide strategic financial guidance and decision support for growth initiatives and business planning.

Requirements

Required Qualifications

• Bachelor's degree in Finance, Accounting, Business, Economics, Healthcare Administration, or related field.
• 2-5 years of relevant experience in financial analysis, healthcare finance, accounting, FP&A, or analytics.
• Advanced Microsoft Excel skills and experience working with large datasets and financial systems.
• Strong analytical and problem-solving skills with ability to translate data into actionable insights.
• Excellent written, verbal, and interpersonal communication skills.
• Proven ability to collaborate effectively across Finance, Operations, Clinical, and business teams.
• Strong organizational and project management skills with ability to manage multiple priorities.

Preferred Qualifications

• Experience in healthcare finance, managed care, Medicare Advantage, value-based care, or risk-bearing organizations.
• Background in health plans, managed care organizations, provider groups, ACOs, IPAs, MSOs, or healthcare services.
• Knowledge of Medicare Advantage products including I-SNP and C-SNP programs.
• Experience analyzing healthcare claims, capitation arrangements, utilization trends, MLR, and risk-based reimbursement models.
• Familiarity with Part D financial reporting, healthcare cost accounting, and accrual methodologies.
• Experience supporting CMS reporting, Medicare Bid development, regulatory filings, or healthcare audits.
• Experience with healthcare analytics and business intelligence tools such as Power BI, Tableau, SQL, or similar platforms.

Location

Not specified.

Compensation & Benefits

Not specified.