David Balencia

David Balencia Email and Phone Number

Director, Finance @ MultiCare Connected Care
David Balencia's Location
Tacoma, Washington, United States, United States
David Balencia's Contact Details

David Balencia work email

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About David Balencia

Healthcare Finance Professional, with 20+ years of healthcare revenue, cost management, and pop. health experience.

David Balencia's Current Company Details
MultiCare Connected Care

Multicare Connected Care

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Director, Finance
David Balencia Work Experience Details
  • Multicare Connected Care
    Director, Finance-Population Health
    Multicare Connected Care Oct 2019 - Present
    Tacoma, Wa, Us
    • Manage finance functions within the Population Health team at MultiCare Connected Care (MCC), an Accountable Care Organization (ACO) and a comprehensive Clinically Integrated Network (CIN), supporting financial reporting for our value-based arrangements.• Financial reporting for Value Based Arrangements (VBA) Connected Business Unit (CBU) to include monthly review and accruals, actual vs. budget variance analysis and writing up the monthly narrative.• Create monthly forecasts and rolling forecasts for the IBU that supports the VBA, Population Health, Care Management, Clinical Value, Provider Network, and Employee Health Plan. • VBA monthly revenue updates for Commercial, Medicaid, MSSP, and Medicare Advantage risk-based contracts and dashboard reporting to include membership lives, estimated projections for value-based revenue, estimated opportunities, downside/upside risk share, and low and high range opportunities.• Reconcile value-based payments (VBP) for accountable care payments (PMPM), incentive quality bonus payments and risk share payments against settlement timelines aligned with VBA contracts. • Employee health plan (EHP) monthly financial analysis by trending PMPMs for internal and external claims, HCG (Health Cost Guidelines), CCHG (Chronic Conditions Hierarchical Grouper), COC (Categories of Care), high-cost claimants over $100k, risk scores, and membership by plan. • Capital planning and strategic initiative long range plans• FTE staffing models, position control creation and maintenance, submission of RTHs (Request to Hire), variance analysis, monthly reporting, forecasting and annual budget. • Annual budget for VBA and Population Health, to include statistics, revenue, FTEs, salaries & wages, all operating expenses.
  • Memorial Hermann Health System
    Finance Project Consultant
    Memorial Hermann Health System Mar 2017 - Apr 2019
    Houston, Texas, Us
    • Crowe Revenue Cycle Analytics (RCA) healthcare system implementation• Provide analyses specific to net revenue performance at corporate level and for all facilities by payor groups and patient types, to identify and explain variances from budget• Prepare and calculate detailed A/R contractual and bad debt/charity reserves• Analyze monthly net revenue calculations for funded payors based on contractual rates and historical patient data• Produce monthly close schedules related to net revenue and Aged A/R• Analyzes payor performance, carve outs analysis, profitability, costs, etc. • Deep understanding of reimbursement mechanisms, contractual arrangements, and costing attributes. • Assist in maintain and administering RCA accounts receivable valuation tool.• Use, RCA, EPSi and Payment Integrity Compass (PIC)/Concuity reporting tools and data for various analysis
  • Cleveland Clinic Abu Dhabi
    Manager, Decision Support & Ebi
    Cleveland Clinic Abu Dhabi Jun 2012 - Sep 2016
    Abu Dhabi, Ae
    • Manage the implementation of the EPSi decision support systems for budget manager (general ledger and payroll), cost manager and Product Line Analyst (PLA)• Manage the preparation, analysis and review of decision support reporting, such as divisional hierarchies, profit and loss templates, drill-down reporting, scheduled reporting and service line or product line reporting.• Coordinate the training of new and established users of the decision support system• Collaborates with finance teams to ensure financial statements, operating metrics, and KPIs are accurate and timely• Build and implement RVU model to be used in decision support system EPSi for labor, pharmacy and supplies• Participates in project planning to ensure effective use of technology and/or business process to meet business needs (i.e. EPSi productivity, Kronos, Lawson)• Align business intelligence initiatives with data warehouse projects through planning related to the Business Intelligence strategy and BI dashboards using Tableau• Overseeing the daily operation and maintenance of the EPSi Cost Accounting/Decision Support System
  • Memorial Hermann Healthcare System
    Manager, Financial Planning & Analysis
    Memorial Hermann Healthcare System Oct 2009 - May 2012
    Houston, Texas, Us
    • Responsible for Texas Medical Center-Hermann Hospital, HVI, & Children’s service line reporting, profromas, net revenue analytics• Responsible for Decision Support service line profitability, analysis, and reporting• Prepare and present net revenue payor group month-end analysis by mix, AA, APD, and CMI adjusted to explain rate and volume variances from budget• Prepare and present month-end supporting schedules such as net rate variance explanations, contractual reserve issues, CDM review, conversions, fin. class changes, and CMI analyses• Bad debt and charity financial impact and trending analyses and reporting package by admission type, payor group, adjustment codes and patient responsibility• Medicare and Medicaid point person for net revenue impact to include a detailed understating of add ons/pass thrus including capital, IME, GME, Outliers/Inliers, DSH/Dispro., bad debt, and organ reimbursement from cost report settlement• Researching government program regulations i.e. NCDs, LCD/LMRPs, Federal Register, Medicare and F.I. transmittals, bulletins, etc.• Responsible for transplant financial reporting for liver, kidney, and pancreas from a net revenue and profitability perspective as well from a Medicare cost report perspective• Budget net revenue for Medicare and Medicaid at detailed level in which net is calculated using projected and budgeted days, cases, CMI and gross revenue applied to base payments, add ons, pass thrus, etc.• Cost center statement reviews, surveys, managed care contract reviews, and expense management responsibilities• Provide additional ad hoc and presentation reporting needs to system executives, CFOs, and directors for monthly operating (MOR) meetings
  • Multicare Health System
    Sr Financial Analyst
    Multicare Health System Sep 2007 - Oct 2009
    Tacoma, Wa, Us
    • Compile and coordinate monthly AR and reserve financial close packet.• Financial reporting of AR, contractuals, deductions, and bad debt & charity.• AR contractual reserve analysis for all hospital billing and physician billing, using zero balance account (ZBA) methodology.• Reported payor mixes, facility and consolidated (gross rev, net rev, gross AR)• Provide analytical and reporting needs to VPs, directors, consultants, auditors. • Point person in revenue cycle for providing PBCs to external auditors • Point person between revenue cycle and finance to ensure appropriate and accurate booking of revenue deductions• Create, develop and maintain EPIC Clarity or HPM reports to provide reliable and accurate data needs• Quarterly trauma reconciliation between FHS and MHS• Analyses of bad debt write-offs, contractuals, admin. adjs. revenues, etc.
  • Seattle Children'S Medical Center
    Sr Accountant
    Seattle Children'S Medical Center Sep 2006 - Oct 2007
    Seattle, Wa, Us
    • Reconcile hospital A/R from sub-ledger billing system to general ledger• A/R contractual reserve analysis for facilities, using zero balance approach• Maintain, update, and review govt. contracts in decision support system• Review payor plans from a financial impact perspective to determine financial reporting needs• Detailed understanding of healthcare billing, contracts and accounts receivables• Revenue analysis by payor, utilization, DRGs, RCCs, etc.• Other finance needs, e.g. lobbying expense analysis, federal mental health grant analysis, survey & bond insurer questionnaires• Work closely with external auditors
  • Multicare Health System
    Financial Analyst
    Multicare Health System Nov 2003 - Aug 2006
    Tacoma, Wa, Us
    • Managed Care payor contract modeling for inpatient and outpatient to include a detailed understanding of CPT/HCPCs, ICD-9s, DRGs, ASCs, APCs, and per diem/case rates• Professional data modeling using CPT/HCPCs and fee schedules• Accounts receivable contractual reserve analysis for facilities, using zero balance approach, paid claims summaries• Profitability analysis by payors, new service, or cost centers, etc.• Chargemaster (CDM) maintenance, daily supply adds, price updates, CDM monthly reporting, and CDM usage reporting• Compile and determine budget pricing at CDM and RVU level for facilities• Ad hoc extensive revenue analysis• Detailed understanding of healthcare billing, contracts and A/R
  • Franciscan Health System
    Ap System Administrator
    Franciscan Health System Nov 2002 - Nov 2003
    Tacoma, Wa, Us
    • Responsible for AP to GL daily interfaces, error/issues resolution with McKesson vendor• Supported various accounting software systems• Performed tests for accounts payable system upgrades• Worked with materials management to streamline purchasing processes from receiving to vendor payment• Verified integrity of data through audits, reviews and analyses• Created and maintained Crystal reports for month-end reporting and ad hoc reporting for management team
  • Davita Inc.
    Staff Accountant/Gl Analyst
    Davita Inc. Oct 1999 - Nov 2002
    Denver, Co, Us
    • Analyzed & explained P&L variances for 32 end-stage renal dialysis centers• Prepared financial statements for over 30 partnerships and affiliated centers• SEC-level corporate consolidated analysis and entries, including investments using equity method• Reconciled high cost drug inventories, A/R, fixed assets, rents/leases, and other balance sheet accounts• Reviewed and analyzed A/R open accounts at patient level • Project lead in physician services analyses

David Balencia Skills

Financial Analysis Revenue Cycle Hospital Reimbursement Medicare/medicaid Reimbursement Healthcare Reimbursement Reserve Analysis Accounts Receivable Financial Reporting Financial Modeling Decision Support Cost Accounting Operating Budgets Service Lines General Ledger Accounts Payable Microsoft Excel Microsoft Office Epsi Hpm Epic Systems Cognos Meditech Lawson General Ledger Oracle Applications Concuity Erehab Crystal Reports Healthcare Medicare Auditing Budgets Accounting Strategic Financial Planning Finance Healthcare Management Payroll Managed Care Healthcare Consulting Fixed Assets Team Leadership Financial Planning Budgeting Annual Budgets Tableau Current Procedural Terminology Kronos Rca Revenue Analysis

David Balencia Education Details

  • University Of Washington Tacoma
    University Of Washington Tacoma
    Accounting

Frequently Asked Questions about David Balencia

What company does David Balencia work for?

David Balencia works for Multicare Connected Care

What is David Balencia's role at the current company?

David Balencia's current role is Director, Finance.

What is David Balencia's email address?

David Balencia's email address is db****@****hoo.com

What is David Balencia's direct phone number?

David Balencia's direct phone number is (253)-372*****

What schools did David Balencia attend?

David Balencia attended University Of Washington Tacoma.

What skills is David Balencia known for?

David Balencia has skills like Financial Analysis, Revenue Cycle, Hospital Reimbursement, Medicare/medicaid Reimbursement, Healthcare Reimbursement, Reserve Analysis, Accounts Receivable, Financial Reporting, Financial Modeling, Decision Support, Cost Accounting, Operating Budgets.

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