Senior Financial Analyst

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AlohaCare is a local, non-profit health plan serving the Medicaid and Medicare dual eligible population. We provide comprehensive managed care to qualifying health plan members through well-established partnerships with quality health care providers and community-governed health centers. Our mission is to serve individuals and communities in the true spirit of aloha by ensuring and advocating access to quality health care for all. This is accomplished with emphasis on prevention and primary care through community health centers that founded us and continue to guide us as well as with others that share our commitment. As Hawaii’s third-largest health plan, AlohaCare offers comprehensive prevention, primary and specialty care coverage in order to successfully build a healthy Hawaii .

The Culture :

AlohaCare employees share a passion for helping Hawaii’s most underserved communities. This passion for helping and caring for others is internalized and applied to our employees through a supportive and positive work environment, healthy work / life balance, continuous communication and a generous benefits package.

AlohaCare’s leadership empowers and engages its employees through frequent diversity, recognition, community, and educational events and programs. AlohaCare has a strong commitment to support Hawaii’s families and reinforces a healthy work / home balance for its employees. Because AlohaCare values honesty, respect and trust with both our internal and external customers, we encourage open-door, two-way communication through daily interactions, employee events and quarterly all-staff meetings. AlohaCare’s comprehensive benefits package includes low cost medical, dental, drug and vision insurance, PTO program, 401k employer contribution, referral bonus and pretax transportation and parking program.

These employee-focused efforts contribute to a friendly, team-oriented culture which is positively reflected into the communities we serve.

The Opportunity :

This position is responsible to directly support the overall financial success of the organization by providing senior level, actionable analysis of financial and operating results, as well as other routine and ad hoc retrospective and prospective financial and operational analysis.

Primary Duties and Responsibilities :

• Performs cost of care analysis – identifying key cost drivers and ongoing monitoring of financial trends.
• Delivers analysis of core product financial indicators for recurring and adhoc research
• Assist with preparation of internal financial and operating reports, including monthly financial statements, KPIs, Finance Committee and Board of Director reports, etc.
• Assist with preparation of external financial and operating reports, including Quarterly and Annual regulatory (HI DOI, HI DHS MED-QUEST, and NAIC) reports.
• Assist with preparation of supporting schedules and analysis for annual financial and regulatory audits.
• Prepare analysis in support of provider network contract negotiations, including provider reimbursements, P4P programs, withholds, and risk share programs.
• Participate in development of annual operating budget.
• Participate in periodic development of financial forecasts.
• Prepare monthly calculations and reconciliations of provider “pass-throughs”; ensure timely processing of pass-through payments.
• Support preparation of Risk Based Capital (RBC), statutory required capital reserves, and regulatory performance bonds calculations; ensure regulatory compliance.
• Provide comprehensive support to the reinsurance programs, including monthly reconciliation of reinsurance receivables, and timely processing of recoveries.
• Develop detailed drill-down analysis to provide corrective actionable insights to Executive Council and Medical Management leadership for total cost of care and administrative expense initiatives.
• Provide analysis to support annual negotiations with DHS MED-Quest to ensure adequate capitation rates.
• Support development of annual Medicare program bid.
• Support monthly detailed reconciliation of membership and capitation revenues to ensure accuracy of premium revenues to organization.
• Support preparation of monthly provider risk pool statements and timely, accurate annual provider risk pool settlements.
• Perform other ad hoc financial analysis, as assigned.
• Responsible to maintain AlohaCare’s confidential information in accordance with AlohaCare policies, and state and federal laws, rules and regulations regarding confidentiality. Employees have access to AlohaCare data based on the data classification assigned to this job title.

Knowledge, Skills, Education, Licensure / Certification and Abilities :

Preferred Requirements

Mental, Physical and Environmental Demands :

Salary Range : $61,000 – $83,000 annually

AlohaCare is committed to providing equal employment opportunity to all applicants in accordance with sound practices and federal and state laws. Our policy prohibits discrimination and harassment because of race, color, religion, sex (including gender identity or expression), pregnancy, age, national origin, ancestry, marital status, arrest and court record, disability, genetic information, sexual orientation, domestic or sexual violence victim status, credit history, citizenship status, military / veterans’ status, or other characteristics protected under applicable state and federal laws, regulations, and / or executive orders.

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