Healthcare Economics Analyst Ii
Current(Edited for length.)•Monitoring and reporting Medicaid and Washington State funded behavioral health expenses for multiple lines of business across multiple company divisions.•Estimating behavioral health expenses for budgeting, forecasting, and analytical purposes.•Analyzing and monitoring behavioral health reimbursement rates and making recommendations for rate adjustments where appropriate.•Coordinating with contracting department and corporate legal counsel in rate setting and contract negotiations.•Calculating and reporting complex shared risk pool arrangements, maintaining accruals for expected risk pool settlements, and preparing risk pool settlement distributions.•Detailed annual budgeting for behavioral health expenses across multiple lines of business and corporate divisions, with quarterly updates for budget projections.•Leading cross-functional projects related to contract analysis and negotiation, shared risk pools, provider invoicing, and financial reconciliations.•Reporting detailed behavioral expense data to the State of Washington and state contractors for rate setting, audits, performance measures, actuarial, risk scoring, and other purposes.•Complex financial analysis and reporting, including allocating expenses, determining accruals, and calculating payables and receivables by corporate division and line of business.•Maintaining SQL data tables for monthly expense and accrual data, with modifications to tables as necessary to add functionality and compatibility with other data sources.•Calculating monthly capitation and regional crisis service payments and ensuring they are issued accurately and in a timely manner.•Management, maintenance, validation, and reporting of large amounts of health care financial data on a monthly, quarterly, and annual schedules.•Writing and maintaining policies and procedures to document operationally critical functions and tasks. •Familiar with Washington State SERI guide for behavioral health services.
