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Job Details

Financial Manager - Medicare

Requisition #: 551189
Location: Johns Hopkins Health Care, Hanover, MD 21076
Category: Finance
Work Shift: Day Shift
Work Week: Full Time
Weekend Work Required: No
Date Posted: June 30, 2022

Who you are:

As the Medicare Financial Manager for Johns Hopkins HealthCare, you are the subject matter expert for the risk revenue program including detailed encounter submission processes. When it comes to analysis and reports, your knowledge of the healthcare service industry (and the Medicare Advantage insurance plan) is relied upon by senior leadership to support the Medicare Advantage line of business.

What you’ll do:

  • Oversee the day to day report creation and analytics around the Medicare Advantage insurance plan, including but not limited to:
    • IBNR validation
    • Trend reporting
    • Client reporting
  • Manage the technical aspects of the risk revenue program including detailed encounter submission processes.
  • Create and manage the current and long range programmatic budgets for the Line of Business
  • Lead the monthly close process for the line of business
  • Manage and support vendor relationships, RFP bid and analytical process.
  • Champion financial analyses to assist senior decision makers within the organization to include ROI’s, plan design, benchmarking, cost containment, medical expense analysis plus any other ad hoc analysis as needed.
  • Manage and develop professional staff
  • Work with other departments and Lines of Business to create efficiencies in the analytical capabilities across Johns Hopkins HealthCare

What you’ll bring:

  • 5+years’ progressively responsible experience performing financial analysis and financial modeling
    • 3+ years’ experience in healthcare insurance services industry is required
  • Knowledge of risk revenue processes for the accurate and complete submission of encounters to CMS
  • Knowledge of financial and accounting concepts
    • Knowledge of healthcare terminology
  • Knowledge of financial analysis with physician and hospital claims and familiarity with professional fee reimbursement as well as CPT, DRG, HCPCS, and ICD code sets
  • Extensive knowledge of spreadsheets and database software.
  • Extensive database experience with ability to access and manipulate significant amounts of complex data and produce meaningful and useful reports for senior management.
    • SQL experience is highly preferred

Who we are:

Johns Hopkins HealthCare (JHHC) is the managed care and health services business of Johns Hopkins Medicine. JHHC is a $3B business serving over 500,000 active members with lines of business in Medicaid, Medicare, commercial, military health, health solutions, and venture investments. JHHC is a leader in provider-sponsored health plans and is poised for future growth.

Many organizations talk about transforming the future of healthcare, at Johns Hopkins HealthCare, we are setting the pace for change within the healthcare industry. We develop innovative, analytics-driven health programs in collaboration with provider partners to drive improved quality and better health outcomes for our members and the communities we serve. If you are interested in improving how healthcare is delivered, and have a passion to be at the forefront of change, JHHC is the place to call home.

If you reside in one of the following states, this position can be considered for virtual work: MD, VA, FL, PA, DE, or District of Columbia

Johns Hopkins Health System and its affiliates are an Equal Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity and expression, age, national origin, mental or physical disability, genetic information, veteran status, or any other status protected by federal, state, or local law.

Johns Hopkins Health System and its affiliates are drug-free workplace employers.

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