Senior Revenue Analyst

Job Summary

Hybrid Work Environment - Must reside in Hawaii
Pay Range: $78,000 - $153,000
Note: Individuals typically begin between the minimum to middle of the pay range

Minimum Qualifications

• Bachelor's degree and five years of related experience; or an equivalent combination of education and related work experience.
• Strong presentation skills to peers, management and executive staff.
• Working knowledge of Medicare Advantage, Medicaid, and/or ACA revenue cycles for payers.
• Strong working knowledge of claims, health plan financial data, and health industry structure.
• Advanced 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 with minimal guidance.
• Interprets financial and enrollment data from internal and external sources, identifying opportunities and problems compared to anticipated outcomes.
• Evaluates financial data needs and identifies and implements solutions for program driving accurate coding and documentation to optimize revenue.
• Develops 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, providing actionable insights to leadership.
• 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, and recommends strategic alternatives.
• Develops, maintains, and analyzes appropriate documentation of desktop procedures for reconciliation and audit needs.
• Builds and maintains in-depth knowledge of revenue structures and regulations and conceptual knowledge of related activities.

Leadership & Continuous Improvement

• Recommends and implements process enhancements to improve the accuracy and efficiency of revenue analysis.
• Mentors junior analysts and may be assigned project lead requiring some resource planning assignments.
• Performs all other miscellaneous responsibilities and duties as assigned or directed.