Job Description

Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 Members with the following programs:

* Medicaid State of Texas Access Reform (STAR) program for low-income children and pregnant women

* Children’s Health Insurance Program (CHIP) for the children of low-income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR

* Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre-existing conditions.

* Community Health Choice (HMO D-SNP), a Medicare Advantage Dual Special Needs plan for people with both Medicare and Medicaid that combines Medicare Part A and Part B benefits, Medicare Part D prescription drug coverage, and Medicaid benefits with additional health benefits like dental, vision, transportation, and more.

Improving Members' experiences is at the heart of every Community position. We strive every day to make sure that our Members have access to the high-quality health care they need and deserve.

Community is accredited by URAC for its health plan operations. We offer care management programs for asthma, diabetes, and high-risk pregnancy. An affiliate of the Harris Health System (Harris Health), Community is financially self-sufficient and receives no financial support from Harris Health or from Harris County taxpayers.

Skills / Requirements

The Senior Decision Support analyst will take a very active role in the planning, preparation and consolidation of the annual operating and capital budgets for the organization and the update of monthly forecasts and financial projections. He/she will be the main point of contact for data preparation and analysis required for internal and actuarial requests, revenue analysis, value-based contract analysis, cost saving initiatives, financial proformas to evaluate new initiatives, process improvement initiatives across the organization and automation of internal processes to ensure a higher level of accuracy in the work delivered by the department.

Essential Functions
Directly support management with coordination of annual operating budget and preparation of monthly forecast and long-term financial projections. Prepares revenue models, claim lag and IBNR analysis for all product lines. Creates financial models to evaluate financial impact of government regulations and market conditions in overall profitability of each line of business.

Supports the organization in the development of financial proformas to evaluate cost saving initiatives and/or financial feasibility when adding new lines of business. Assists in the collection and establishment of KPIs for all the areas in the organization to facilitate financial and operational analysis.

Assists in the preparation of variance analysis and financial dashboards to illustrate gross margin financial performance and budget to actual analysis for each admin unit in the organization.

Takes active role in the development of analytical methodologies to evaluate workforce planning approach in all areas of the organization, provider contracting & utilization, performance by type of service & risk group and benchmarking across the organization.

Assists in the maintenance and support of the budget software system. Identify opportunities to automate current systems by using software planning tool and leads implementation of projects that will minimize manual processes and will allow a higher level of efficiency and accuracy when preparing financial models.

Marginal Functions
Assist in training and mentoring of junior analysts as needed
Supports management in the development of position control processes and procedures that align with the organization workforce planning strategy

MINIMUM QUALIFICATIONS:

Required
Education/Specialized Training/Licensure:

  • Bachelor's degree in Finance, Economics. Mathematics, Healthcare Administration, Computer Science or related field  

Preferred: Master's degree, MBA

Work Experience (Years and Area):

  • 5+ years managed care experience, decision support, medical economics or healthcare informatics.
  • 3+ years data analysis and computer coding (SQL/SAS) required.
  • Healthcare information technology experience
  • Strong communication skills

Software Proficiencies:

  • Advance proficiency in Excel, 3+ years' experience with SQL and other programing tools (visual basic and Excel macros).
  • Basic knowledge of Power Point and Microsoft Word.
  • Knowledge of dashboard tools as Power BI or Tableau, Oracle or any other Financial Planning software tool.

Application Instructions

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