Senior Government Healthcare Financial Consultant Reporting and Monitoring

Senior Government Healthcare Financial Consultant Reporting and Monitoring

Mercer Health & Benefits, LLC is seeking candidates for the following full-time position based in the Salt Lake City, UT office. A telecommuting / hybrid work schedule may be permitted within a commutable distance from the worksite, in accordance with company policies.

We will count on you to :

Conduct in-depth data analysis and prepare financial reports for organizations within the healthcare sector. Gather and organize financial data from various sources, including claims databases and financial management systems, to facilitate effective reporting and analysis. Utilize advanced Excel functions, statistical analysis software (e.g., R or SAS), and data visualization tools (e.g., Tableau or Power BI) to conduct preliminary data analysis related to key performance metrics and quarterly financial and operational reports. Assist in audits, such as Medical Loss Ratios (MLR) and Rate Development Template (RDT) audits, ensuring that RDTs are accurately reported by Managed Care Organizations. Partner with state governments to examine financial reports in order to understand emerging Medicaid health care experience as well as the financial performance of managed care organizations. Interact with credentialed actuaries and financial executives to ensure Medicaid dollars are being utilized efficiently. Work with client and team project managers to clearly define the scope, timelines and deliverable(s) of projects; ensure development of essential project documents, including budget and work plans. Collaborate with team members to discuss findings and insights, contributing to the overall success of consulting projects while engaging in professional development to enhance analytical skills and knowledge of compliance requirements.

What you need to have :

Must have a Bachelor's degree or foreign equivalent in Public Administration, Finance, Information Systems, or a related field plus three (3) years of experience in the position offered or a related position. Alternatively, employer will accept a Master's degree or foreign equivalent in Public Administration, Finance, Information Systems, or a related field plus one (1) year of experience in the position offered or a related position. Must have three (3) years (or one [1] year with a Master's) of experience with all of the following : Performing healthcare financial analysis of Medicaid health plans, including medical loss ratio review and expense variance analysis; Creating financial models for Medicaid health plans using Microsoft Excel advanced formulas including Index Match and vlookup; Applying Medicaid rate setting methodologies and processes; Auditing managed Medicaid financial healthcare data including income statement, balance sheet, claims, and incurred but not reported calculations; Analyzing large Medicaid claims and capitation data sets using advanced programs including SAS, R, and Qlik Sense; Reviewing and analyzing cost report data of Medicaid-specific provider groups.