FASTTEK GLOBALpowered by Fast Switch - Great Lakes
(734) 744-9373
Detroit, Michigan
Financial Analyst III Government Programs #906722
Job Description:
Duties: General Summary:
To assist the Financial Services division, Risk Adjustment Financial Reporting and Analysis department in ensuring responsibilities for reporting of Government Program revenue for Medicare Advantage / MMP product lines. 
Principal Duties and Responsibilities:
  • Compile CMS premium payment and revenue reconciliation reports for monthly financial close process; file payment issues with CMS and monitor response; monitor MMR accruals; estimate risk adjustment premium impact for midyear and final reconciliation with CMS; allocation of premium to at-risk provider networks
  • Primary user of Risk Adjustment vendor application. Monitor vendor system for assessment of RAPS and EDPS data submission / acceptance status, progress of risk projects, utilization of Vendor supplemental data to assist in risk adjustment project pricing, ongoing assessment of data integrity and completeness issues that may impact risk adjustment project valuation.
  • Utilize CMS government program regulatory communications and knowledge and understanding of Risk Adjustment program operations, Risk Adjustment payment methods, HCC-Coding models, to assess impact on government program financial reporting.
  • SME Liaison to multiple departments within the organization, including but not limited to Provider Services, Network Management, Actuarial Services, Underwriting, Financial Analysis, Financial Services, Risk Adjustment, IT-Business Intelligence, Data Analytics, Henry Ford Health System Revenue Cycle for expertise in government programs, payment methods, revenue attribution, and risk adjustment.
  • Maintenance of the following queries and analysis: Reconciliation reports for CMS MA Part C/D Risk Adjustment program receivables and payables for monthly accounting needs. Monitor accruals for final reconciliation with CMS.
  • Maintenance of the following queries and analysis: Reconciliation reports for CMS Part D Reinsurance, Low Income Cost Sharing, Risk Sharing program receivables and payables for monthly accounting needs. Monitor accruals for final reconciliation with CMS.
  • Develop and enhance reporting capabilities for financial and operational performance.
  • Support annual financial reporting activities including CMS bid filings, RFP on financial Risk Adjustment projects, Employer Group Rate Renewals, financial audits, CMS Attestations, Medical Loss Ratio annual filing requirements, CMS premium, risk adjustment, member and provider revenue budgets.
  • Analyze department reports to identify data integrity issues, system and programming problems, and work with management to develop and implement improvement solutions.
  • Assist department in performing routine assignments, ad-hoc projects and meeting established deadlines. Engage assistance of departmental support analysts in completion of required responsibilities where appropriate.
  • Basic Accounting principles for Journal Entry preparation and Account reconciliation.
  • Perform other related duties as assigned.
Skills: Experience Required:
  • Four (4) years of Finance experience in Health Care Insurance or Managed Care Organization
  • Three (3) to five (5) years of experience developing, analyzing, interpreting & trending data
  • Three (3) years of experience with Medicare Advantage, Medicare Part D, Medicaid or Qualified Health Plans or Affordable Care Act
  • Strong understanding of Risk Score, CMS Risk Adjustment HCC and RxHCC models, RAPS/EDPS data, and impact on premiums in government programs
  • Proficient knowledge of MS Office products Advanced Access, Advanced Excel, Power Point, and Word
  • Experience in health care finance, claims processing, and Medicare and Medicare/Medicaid program payment methods
  • Accounting and finance principles as they relate to revenue payments, claims, and membership data, financial projections, variance analysis
Skills and Abilities:
  • Knowledge of business principles and functions
  • Proficient knowledge of Windows – Excel and/or Access and data extraction/analytical tools
  • Proficient at using various data sources to develop relevant reporting tools, and to use those tools to enhance processes and procedures
  • Ability to research, analyze, interpret, trend, and implement process improvement initiatives
  • Ability to collect and prepare data for written/oral presentation – report creation and generation
  • The ability to work effectively with all levels within the organization
  • Excellent written and verbal communication skills
  • Well defined problem solving and decision making skills
  • Ability to collect and prepare pertinent data for report creation and generation
  • Highly motivated self-starter with strong work ethic and professional attitude
  • Attention to detail
  • Master’s degree preferred (Finance, Business Administration, etc.)
  • Two (2) years managing projects and initiatives designed to improve business operations
  • Prior experience with Change Healthcare suite of Medicare Advantage, Medicaid Suite of applications such as Risk View, Encounter Complete, strongly preferred
  • Knowledge of Facets or other Health Insurance Claims/Membership systems
  • Experience with Oracle Financials
  • Proficiency in Power BI and or Tableau
Education Required:
  • Bachelor’s degree in Finance, Data Analytics, Statistics, Health Care Services Management, Business, or other technical focus; (must include financial or accounting related course work)
Required Skills:
  • SQL
  • Accounting
  • Medicare
  • self-starter
Additional Info:
At FastTek Global, Our Purpose is Our People and Our Planet. We come to work each day and are reminded we are helping people find their success stories. Also, Doing the right thing is our mantra.  We act responsibly, give back to the communities we serve and have a little fun along the way.
We have been doing this with pride, dedication and plain, old-fashioned hard work for 24 years!
FastTek Global is financially strong, privately held company that is 100% consultant and client focused.
We've differentiated ourselves by being fast, flexible, creative and honest. Throw out everything you've heard, seen, or felt about every other IT Consulting company. We do unique things and we do them for Fortune 10, Fortune 500, and technology start-up companies.
Our benefits are second to none and thanks to our flexible benefit options you can choose the benefits you need or want, options include:
  • Medical and Dental (FastTek pays majority of the medical program)
  • Vision
  • Personal Time Off (PTO) Program
  • Long Term Disability (100% paid)
  • Life Insurance (100% paid)
  • 401(k) with immediate vesting and 3% (of salary) dollar-for-dollar match
Plus, we have a lucrative employee referral program and an employee recognition culture.
FastTek Global was named one of the Top Work Places in Michigan by the Detroit Free Press in 2013, 2014, 2015, 2016, 2017, 2018, 2019, 2020, 2021 and 2022!
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