Department: 500735 Government Programs
Facility: Hometown Health
Reno, NV
Schedule: Full Time - Eligible for Benefits
Shift: Day
Hours: 0800 to 1700
Job Details:
  • Position Purpose:

    The purpose of the Medicare Lead Revenue Analyst position is to participate in the design, build, documentation, and support of the Financial and Business reporting requirements of Senior Care Plus; to work closely with end-users to gather report requirements; to ensure proper testing and validation of data elements on the finished product; to participate in the resolution of reporting problems; to perform reporting analysis and modeling utilizing a variety of systems; to provide analytical support on various strategies to ensure company goals are met; to propose opportunities in maximizing our reimbursement based on CMS-HCC Model and Methodology;  to propose improvements in automation to optimize processes where appropriate and, as appropriate, to assist with the support of the Medicare Advantage Risk Adjustment and Payment System and ultimate Centers for Medicare & Medicaid (CMS) Reimbursement.

    Nature and Scope:

    Under the direction of Hometown Health Senior Leadership and the Director of Government Programs, this position assists in the development of the Financial and Business reporting solutions for Senior Care Plus utilizing a variety of source systems and development tools. Included within the scope of this position the incumbent will perform data extraction, analysis, report design, report build, solution deployment, and draft documentation to support the Financial and Business reporting solutions for Senior Care Plus. Accurate and timely project status feedback is expected to ensure compliance with established timelines.

     

    KNOWLEDGE, SKILLS & ABILITIES:

     

    1.       General knowledge of Health Insurance, Managed Care, Benefit Design, Nevada Revised Statutes (NRS), Nevada Administrative Codes (NAC), Medicare Advantage Prescription Drug plans (MA-PD) and Federal Regulations.

     

    2.       The job function requires an ongoing direct communication with Managers and Directors in all departments, and the ability to analyze user requirements and generate report specifications as well as the ability to translate data into business context.

     

    3.       All summary and analysis reporting projects must be mechanically, statistically and theoretically accurate.

     

    4.       Additional duties may include working with an outside vendor to provide or collect data or perform system updates as needed.

     

    5.       This position also acquires and maintains comprehension of industry specific knowledge to initiate, coordinate, and provide expertise in decision support analytic projects.

     

    6.       The major challenge of this position is to ensure the Financial Business reporting solutions are accurate, timely, and meaningful.

     

    7.       Most of the work in this position will be performed independently or as part of a self-directed work team. Minimal detailed instruction will be given.

     

    8.       This position will have access to propriety information. This mandates high standards of professionalism, communications, performance, and respect for confidentiality.

     

     

    Philosophy consistent with the corporate culture, Fundamentals and Standards of Conduct of Renown Health. It is common to encounter potential hazards in the healthcare environment. Some of these hazards could include, but are

    not limited to: Radiation, Toxic Chemicals, Biological Hazards, Heat, Noise, Dust and Stress. Renown Health has a

    Safety Management Program in place addressing these issues.

     

    This position does not provide patient care.

    The foregoing description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills and efforts or work conditions associated with the job. It is intended to be an accurate reflection of the general nature and level of the job.

    Minimum Qualifications:  Requirements - Required and/or Preferred

    Education:

    Must have working-level knowledge of the English language, including reading, writing and speaking English. Four-year degree from an accredited college preferred. Bachelor’s degree in Management Information Systems, Business, Computer Science strongly preferred, but not required. Healthcare Administration or other Healthcare field will receive preference.

    Experience:

    Minimum of two years experience with applications as a clinical or financial user or technical specialist and at least one year’s experience as a report developer. Experience with Medicare Advantage plans or Medicare Managed Care preferred. Preference will be given to individuals with experience in healthcare systems. Experience with EPIC, Clarity and Reporting Workbench is desired.

    License(s):

    None.

    Certification(s):

    None.

    Computer / Typing:

    Must be proficient with Microsoft Office Suite, including Outlook, PowerPoint, Excel and Word and have the ability to use the computer to complete online learning requirements for job-specific competencies, access online forms and policies, complete online benefits enrollment, etc.  Typing 35 WPM.



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