Computer Enterprises, Inc. Hanover , MD 21076
Sr. Cost of Care/Provider Contract Analyst
This Provider Contract/Cost of Care Analyst, Sr. will be responsible for reporting and analysis for Medicaid providing all analytical needs.
You will create and interpret reports, ad hoc reporting, drill down analysis to support performance management and evaluation health management cost of care initiatives. Responsible for estimating and monitoring and providing analytical support. Strong relationship with Medicaid Regional Leadership including regional Presidents, Finance VP, Medical Directors, etc.
Provides Medicaid P&L, actuarial and enterprise financial support in the analysis of medical expenses, medical expense trend, membership, revenue, medical loss ratio and drill downs.
Provides Medicaid Business Units and leaders with analysis of revenue and medical costs on a restated basis and reconcile restated financial results to results reported in financial statements in prior periods to help strengthen performance management.
Independently develops sound applications and models necessary to efficiently measure, understand, monitor and explain the companys medical cost structure and restated financial results.
Proactively identifies medical expense trend opportunities and risks throughout the company such as trend anomalies, outliers, behaviors etc.
Completes the most diverse and complicated projects and performs complex analytical studies.
Measures and evaluates risks, models and forecasts future implications and recommends actions, consistent with established analytical methods and standards.
Performs independent valuation of corporate medical expense performance metrics and valuation of management program initiatives
Prepares comprehensive documented observations, analyses and interpretations of results including technical reports, summaries and quantitative analyses.
Cost of Care, Cost Analyst, SQL, unit/cost, PMPM, Cost Analysis, Healthcare, Medicaid