Financial services representative Jobs in Orange, CA

Manager, Financial Services Managed Care Analytics

Our client, a leading integrated healthcare organization, is seeking a Manager, Financial Services Managed Care Analytics to lead financial analysis and reporting initiatives that support managed care contracting and organizational strategy. This leadership role is responsible for providing financial insights, reimbursement modeling, contract analysis, and operational reporting to support executive decision-making across multiple healthcare entities. The ideal candidate has a strong background in healthcare finance, managed care analytics, reimbursement methodologies, and financial modeling, along with the ability to collaborate across finance, contracting, operations, and executive leadership.

Position Summary

The Manager, Financial Services Managed Care Analytics is responsible for advancing the organization's managed care financial strategy through comprehensive financial analysis, contract modeling, reporting, and operational support. This role oversees the development of financial reporting, analyzes complex payer agreements, identifies trends, and provides actionable recommendations that support contract negotiations and business performance.

Key Responsibilities

• Lead financial analysis supporting managed care contracting strategies and organizational initiatives.
• Analyze financial and operational data from multiple healthcare systems, including data warehouses, cost accounting systems, general ledger, budgeting systems, patient billing data, and payer capitation reports.
• Evaluate complex commercial and government payer agreements, including Medicare Advantage, Medi-Cal, Accountable Care Organizations (ACOs), Direct-to-Employer contracts, Medical Group agreements, and Ambulatory reimbursement arrangements.
• Develop reimbursement models and financial projections to support payer contract negotiations.
• Create and maintain reporting tools that monitor payer performance, reimbursement trends, and financial outcomes.
• Prepare executive-level financial reports, dashboards, and monthly reporting packages.
• Support monthly financial close by identifying trends, variances, and operational opportunities.
• Analyze medical expense fluctuations and communicate findings to leadership.
• Partner with finance, managed care contracting, actuarial, operational, and executive teams to support strategic initiatives.
• Design and execute complex SQL queries to support reporting and financial analysis.
• Ensure the accuracy and integrity of financial reporting and data analysis.
• Respond to audit requests and provide supporting financial documentation.
• Collaborate with external vendors to resolve financial reporting or system-related issues.
• Identify complex financial and operational challenges and develop data-driven recommendations for improvement.
• Complete ad hoc financial analyses and executive reporting requests while meeting established deadlines.

Requirements

• Bachelor's degree in Business, Finance, Healthcare Administration, Accounting, or a related field.
• Minimum of 2 years of experience in healthcare financial analysis, preferably within a managed care analytics environment.
• Strong knowledge of managed care reimbursement methodologies and healthcare finance.
• Advanced proficiency with SQL, Epic, Microsoft Excel (advanced formulas, pivot tables, financial modeling), and Microsoft Office Suite.
• Experience working with large healthcare datasets and financial reporting.
• Excellent analytical, organizational, and problem-solving skills.
• Strong communication skills with the ability to present financial information to leadership.
• Ability to prioritize multiple projects while meeting deadlines in a fast-paced environment.

Preferred Qualifications

Experience with Snowflake, healthcare accounting systems, cost accounting systems, patient billing systems, financial forecasting, and reimbursement models.