Managed Care Finance Manager

Robert Half
November 26, 2021
Anaheim, CA
Job Type


Ref ID: 00291-0012064431

Classification: Finance Manager

Compensation: $51.46 to $68.00 hourly

A prestigious medical group in the Anaheim area is seeking a talented Managed Care Finance Manager to join their organization. The responsibilities for the Managed Care Finance Manager are below:

  • Understanding of and experience with how revenue is derived in Medicare, how risk adjustment ties in, how risk adjustment activities occur within CMS, and midyear and final scores cutoff period on claims encounters
  • Pull data with SQL, such as claims and capitation data, to build risk pool statements
  • Mitigate and resolve issues found, such as data quality or completeness issues
  • Understanding of agreement structure and what actual charges are
  • Keep track of various financial pieces of contracts, deadlines and timelines
  • Keep track of settlements and if externals are following through on payments
  • Ability to produce standard reports, and also act quickly on ad-hoc requests from leadership
  • Ability to be team-oriented and collaborate with existing team and other dept
  • Pull data, build automation, work with large data sets, and make sense of how to join and compare disparate tables and bridge different data sets

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