Financial Consultant National Medicare Finance HMO Maryland Job in Not Specified, Maryland US
Financial Consultant National Medicare Finance HMO Maryland
This position is responsible for preparing the annual Medicare HMO cost reports, other HMO statutory filings, and monthly reimbursement revenue PMPM rates for one or more Kaiser regions. The position is responsible for gathering reimbursement data, costs and statistics, and ensuring data accuracy and completeness. Position is responsible for analyzing and reporting on key drivers and variances of Medicare Cost reimbursement. Position provides support to internal and external audits. Essential Functions: -Prepare annual Medicare HMO cost reports and other statutory filings for one or more regions. -Prepare monthly PMPM rate estimate and update quarterly Data Integrity Checklist and rate model, review data source checklist, and prepare rate model checklist -Prepare analysis of trends and changes to Medicare Cost reimbursement. Identify and understand changes in region's operations and the potential impact to reimbursement revenue estimates -Ensure data sources, processes and procedures are standardized, where possible across regions -Support internal and external reimbursement audits -Provide peer review of the work of other reimbursement staff -Develop and/or update desk procedures for the preparation of cost reports and revenue estimates Qualifications: Basic Qualifications: - Bachelors degree in Finance, Accounting, or related area, or equivalent experience. - 8 or moreyears of financial analysis or related experience. - Experience with regularly contributing to the development of new financial analysis concepts, techniques, and standards. - Proficiency in PC based word processing and spreadsheet applications, including advanced functions such as graphics, pivot tables, macros and database management. Proficiency in SAS (mainframe or PC). Preferred Qualifications: - 3 or more years experience in preparing and reviewing Medicare HMO Cost Reports - 8 or more years experience in Healthcare - 3 or more years experience in Accounting, Financial Reporting or Financial Planning - 2 or more years of internal or external audit experience - 2 or more years experience working with representatives from the Centers for Medicare and Medicaid Services (CMS) preferred - 3 or more years experience working with healthcare claims data - 3 or years experience in Medicare reimbursement - Knowledge of Medicare reimbursement rules and regulations - Cost accounting skills - CPA, CMA or MBA