Financial Analyst Iii
Current• Complete monthly performance models to estimate claims reserves, calculate utilization by market, forecast variance and JE support for intercompany transfers.• Developed projection models which included prior year utilization and projected membership for the Medical Expense budgeting for 6 markets (overall in excess of $1B in 2016 & 2017).• Assisted with 2015 & 2016 annual rate setting for 4 markets totaling $400M annually through data gathering and discussions with the Clinical Team to determine explanations for anomalies.• Work with IT to deliver business objectives and validate the reports through UAT.• Analyzed and developed staffing models and utilization metrics from State Databooks for 6 RFP’s to provide senior management with estimates for entry into new markets and products.• Prepared complex regulatory reporting to classify claims to meet State reporting requirements from internal classifications.