- Direct Placement
- Rancho Cucamonga, CA
Our Client is a not-for-profit, rapidly growing Medi-Cal and Medicare health plan serving over 1,138,447 residents of the Riverside and San Bernardino counties. Our client maintains a Positive Team Culture as demonstrated by being voted by Los Angeles News Group readers as "Favorite Overall Company To Work For, "Favorite Training Program, and "Favorite Workplace Culture in their 2014 Winning Workplaces survey.
FINANCIAL ANALYST III Prescription Drug Event (PDE)
The position’s responsibilities include conducting lifecycle activities to include requirements analysis and design, developing analysis and reporting capabilities, and continuously monitoring performance
- Design, create and maintain processes to ensure Finance is in compliance with CMS regulations regarding Part D
- Reconcile PDE’s to the legibility and pharmacy data as required by CMS.
- Develop a process to address overpayment reimbursement back to CMS
- Assist in development of a Finance Data Warehouse to track CMS payment data to use in the reconciliation processes
- Perform analysis of the efficiency and effectiveness of current departmental processes and procedures and ultimately help to implement identified improvements and streamline processes.
- Prepare, analyze and reconcile financial data from organization’s operations.
- Develop and implement data collection systems and other strategies that optimize statistical efficiency and data quality.
- Acquire data from primary or secondary data sources and maintain databases/data systems.
- Identify, analyze, and interpret trends or patterns in complex data sets.
- Support audit requests for data and develop responses from internal and external auditors.
- Work closely with various corporate departments to communicate and collect information required for compliance purposes
- Assist with annual and periodic government reporting requirements
- Any other duties as required to ensure Health Plan operations are successful.
SKILLS & QUALIFICATIONS
Possession of a Bachelor’s Degree is required.
Five (5) years’ experience with Finance is required.
Experience with SQL and Access is required.
Managed care experience is preferred.
COMPENSATION | POSITION CLASSIFICATION
- Commensurate with Experience
- Full Time | Contract Assignment