Financial Analyst Job at MSO of Puerto Rico, LLC
LE0006 MSO of Puerto Rico, LLC
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Job Description
POSITION DESCRIPTION
This position is responsible for analyzing MSO payments. Based on this, maintains and prepares all necessary supporting reports, documents and analyses to IPA’s and Non-IPAs. In addition, this position will work in the monthly, quarterly and annual financial reports, utilization data and validations in accordance with the MSO workflows, policies and procedures, in order to control the Company’s costs. Based on this, maintains and prepares all necessary supporting reports, documents and analyses to support management business decisions. Also, this position will analyze the financial feasibility of all contracts with providers.
RESPONSIBILITIES
- Analyzes, verifies and prepares all documentation necessary to support the following monthly payments:
- IPA Providers and PMG monthly capitation and other payments
- Non IPA Providers monthly capitation and other payments
- Admitting Physician Program payments (all regions)
- Special Agremeent payments as contracted with providers
- Quality Fee monthly payment
- Exclusivity agreement payments
- Other Manual payments resquested
- IPA & Non IPA Financial Statement Analyses:
- Request and maintains the IPAs & Non IPAs Financial Statement Reporting Package
- Reconciliation of Memberships and PCPs presented in the Financial Statement and Capitation payments
- Analyze claims presented in the Financial Statement by IPAs. Explains monthly/quarterly fluctuations of such expenses
- Maintains and determine the allocation methodology for the transaction included in the Manual Tab. Explains such distributions to the IPAs
- Prepare adhoc analyses for Management business decisions, such as:
PCP compensation models IPAs dollar contribution to the Company Incentives programs IPA B F Financial Statement comparison and financial performance Maintains the list of IPA B PCPs assigned to the differente administrations Calculate the Quality Fee for IPA A and IPA B
- Preferred Provider Network Surplus Incentive payment
- Validate and request Urgent Care Incentives.
- Prepare, validate and request Value Based incentives.
- Special Agreement monthly and quarterly analysis for payments.
- Verify the accuracy and completeness of the information provided to other departments. This information must be updated at any appropriate time. (i.e. Utilizations and costs reports, Eligibility and Retro deletions reports, etc.)
- Prepares the adequate documentation in order to validate the capitation and quality fee payments presented in the Financial Reports (monthly, quarterly and annual).
- Maintain and keep track of the changes required for the providers’ information that could affect general reporting and payments.
- Liaison of information between the Network Management, Contracting and MMM PMC Finance Division for Non IPAs and IPAs.
- Prepare and analyze Contracting Dashboard
- Evaluate the financial feasibility of contracts’ compensations.
- Report to ASES monthly capitation payments related to APP, Specialist, PMG for both line of business.
- Reponsible of all internal or external audit process.
- Responsible of new projects for automatice the Capitation process for IPA- PCP and specialists, new compensation process, etc.
- Adhoc Reports, analysis or payments.
- Other tasks as assigned by MSO Finance Manager and/or Director
EDUCATION AND EXPERIENCE
Minimum Requirements:
- Bachelor's degree (BA) Administration from four-year College or university or equivalent experience.
- Major should be in Accounting with a three years minimum experience in similar position or equivalent experience.
- Two to three years minimum experience and/or training related to Contract analisys or equivalent combination of education and experience.
- Computer literate In Microsoft Office, Outlook, and preferably knows industry systems like MP, QNXT, OnBase.
LANGUAGE SKILLS
Ability to read, analyzes, and interprets general business periodicals, professional journals, technical procedures, or governmental regulations. Ability to write reports, business correspondence, and procedure manuals. Ability to effectively present information and respond to questions from managers, clients, customers, and the general public.
MATHEMATICAL SKILLS
Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, and percentages. Ability to compute rate, ratio, and percent and to draw and interpret bar graphs.
GENERAL SKILLS
- Bilingual (English – Spanish)
- Manage and solve problems.
- Time management skills; establishing priorities and accomplishing tasks in an accurate and timely basis.
- Strong healthcare knowledge.
- Oral and written communication skills.
PHYSICAL/MENTAL DEMANDS
While working the employee is walking, standing, talking and listening most of the time. The job also requires being able to reach objects with arms and hands.
INTERPERSONAL SKILLS
The responsibilities of this position require continuous interaction with managers and providers in order to solve problems and offer feedback.
ENVIRONMENTAL/WORKING CONDITIONS
Normal busy office environment. Moderate noise (examples: business office with computers and printers, light traffic)
This description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, knowledge, skills, abilities and working conditions may change as needs evolve.
If you like wild growth and working with happy, enthusiastic over-achievers, you'll enjoy your career with us!
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