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Health Insurance, Healthcare

Revenue Analyst II

Honolulu, HIHybridFull TimePosted 2 months agoVisa sponsorship available

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Required skills

  • revenue analysis
  • forecasting
  • financial data
  • enrollment data
  • variance analysis
  • regulatory guidelines
  • process enhancements
  • Microsoft Excel
  • claims data
  • health plan financial data

Nice to have

  • risk adjustment
  • RAF
  • audit

Role summary

The Revenue Analyst II is responsible for analyzing and forecasting revenue streams, including premium revenue and risk adjustment payments, for health plan lines of business. This role involves gathering and interpreting financial and enrollment data, maintaining financial models to assess the impact of regulatory changes and market dynamics, and performing variance analysis. The analyst will ensure adherence to internal policies and regulatory guidelines, maintain documentation for reconciliation and audit purposes, and collaborate with actuarial, finance, compliance, and operations teams. Additionally, the role focuses on identifying process improvements for efficiency and accuracy, and providing informal guidance to new team members. A Bachelor's degree and four years of related experience are required, along with strong communication skills and working knowledge of financial data presentation, health industry data, and Microsoft Office applications.

  1. Reporting, Research & Analysis
    • Analyses 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.
  2. Compliance & Documentation
    • Ensure 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.
  3. Leadership & Continuous Improvement
    • Identify gaps and assist in implementing process enhancements to improve the accuracy and efficiency of revenue analysis.
      Provide informal guidance to new team members.
  4. Performs all other miscellaneous responsibilities and duties as assigned or directed.

#LI-Hybrid

Qualifications
  1. Bachelor's degree and four years of related experience; or an equivalent combination of education and related work experience.
  2. Strong oral and written communication skills for presenting complex information.
  3. Working knowledge of the techniques used to present financial or statistical data.
  4. Working knowledge of claims, health plan financial data, and health industry structure.
  5. Intermediate working knowledge of Microsoft Office applications, including but not limited to Word, Excel, Outlook, and PowerPoint.
Ready to apply?
You'll be redirected to Hawaii Medical Service Association's application page.

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