Job Description
CORE EXPECTATIONS:
· Perform key responsibilities as detailed in this job description in a dependable, responsible, and positive manner, consistent with all state and federal guidelines.
· Serve as a role model by exemplifying professional behavior, language, skills, and attire in order to promptly and accurately serve the needs of stakeholders, members and their families.
· Assure adherence to policies and procedures so that all work is of the highest quality and delivered in the most culturally competent and cost-effective manner.
· Promote and manage diversity and acceptance within the organization and with all members and stakeholders by honoring and respecting their individuality, dignity and rights.
· Offer suggestions and develop solutions to help promote effective and efficient work processes and innovative programs.
· Actively participate in required meetings and complete all mandatory trainings.
· Maintain high levels of advocacy and member confidentiality to ensure the success of the organization and our mission.
· Assist in assuring both internal and external program integrity by being alert to and reporting suspected instances of provider and employee fraud, waste or abuse.
ESSENTIAL FUNCTIONS:
· Coordinate with various teams and departments through effective communication, report generation, solution development and team building.
· Provide or work with various departments to provide, and present various complex financial analyses and reports to Utilization Management Committee, the Clinical, Finance and Network Operations Departments.
· Maintain, modify and create SQL code used for financial analysis and reports.
· Identify, research and bring to resolution any issues with the financial data and reports.
· Develop detailed financial projections.
· Review monthly Quality Assurance Reports prior to issuance to Finance Executive Staff.
· Coordinate the processing of compliance claims adjustments and reporting results to the Compliance Department.
· Development of Value Based Contracting Models and Evaluation of Value Based Contracting.
POSITION REQUIREMENTS:
· Education: Bachelor’s degree in Finance, Accounting, Economics or Mathematics
· License/Certification: N/A
· Relevant Work Experience: Minimum of 5 years of experience in financial forecasting and analysis
SKILLS:
· Extensive knowledge of Microsoft Office applications
· Proficient in using SQL, including querying and troubleshooting
· Thorough understanding of data manipulations and reconciliation
· Excellent analytical skills
· Excellent interpersonal and verbal and written communication skills
· Able to work independently
Company Description
TechLink Systems is a privately held IT Consulting Firm that provides Consulting Services to organizations nationwide. TechLink Systems is a certified MWOBE and has been in business since 1998. Our network spans all major U.S. metropolitan areas touched by major sectors such as entertainment and leisure, finance, industry and government, health sciences, and information technology. Whether you are a client seeking IT services and support or a candidate searching for new opportunities, TechLink System's outstanding customer service and dedication will exceed your expectations in the marketplace! TechLink has 6 regional offices located in San Francisco, Los Angeles, New York City, Philadelphia, Manila, and Bangalore. http://www.techlinksystems.com/ Awards: -Ranked Top 500 Asian-Owned & Asian Pacific American-Owned Businesses in the US -Ranked Top 100 Diversity-Owned & Privately-Owned Businesses in California -Ranked INC500 Fastest Growing Private Companies -Ranked Top 100 Largest Women Owned Business San Francisco Business Times -Ranked 50 Largest Minority-Owned Companies San Francisco Business Times - Ranked in Top 100 Woman Owned Business in the US, Diversity Business -Ranked in the Top 10 Minority-Owned Businesses in the Philadelphia Business Journal -Ranked in the Top 50 Woman-Owned Businesses in the 2014 Philadelphia Business Journal