Revenue Analyst II

Job Summary

Hybrid Work Environment - Must reside in Hawaii
Note: Individuals typically begin between the minimum to middle of the pay range
Focused on HMSA's Government Programs plans (Medicare, Medicaid, ACA), extracts data from multiple internal and external sources, provides statistical, financial, and business research and analysis to help HMSA manage the MA, QI, and ACA lines of business financial revenue performance.

Minimum Qualifications

• Bachelor's degree and four years of related experience; or an equivalent combination of education and related work experience.
• Strong oral and written communication skills for presenting complex information.
• Working knowledge of the techniques used to present financial or statistical data.
• Working knowledge of claims, health plan financial data, and health industry structure.
• Intermediate working knowledge of Microsoft Office applications, including but not limited to Word, Excel, Outlook, and PowerPoint.

Duties And Responsibilities

• Reporting, Research & Analysis:
• Analyzes and forecasts premium revenue, risk adjustment payments, and other revenue streams related to lines of business using prescribed guidelines or policies.
• Gathers, validates, and interprets financial and enrollment data from internal and external sources.
• Supports RAF and financial data needs of program driving accurate coding and documentation to optimize revenue from evaluation and interpretation of the information.
• Runs and maintains financial models to assess the impact of regulatory changes, enrollment trends, and market dynamics on revenue.
• Variance analysis: identify and explain variances between actual and projected revenue.
• Collaborates with actuarial, finance, compliance and operations teams to ensure accurate revenue recognition and reporting.
• Compliance & Documentation:
• Ensures all revenue analysis and reporting adhere to internal policies and regulatory guidelines.
• Develops and maintains appropriate documentation of desktop procedures for reconciliation and audit needs.
• Maintains working level knowledge of revenue structures and regulations.
• Leadership & Continuous Improvement:
• Identifies gaps and assists in implementing process enhancements to improve the accuracy and efficiency of revenue analysis.
• Provides informal guidance to new team members.
• Performs all other miscellaneous responsibilities and duties as assigned or directed.