Capitation Analyst (REMOTE)

Elite Workforce, LLC Remote
capitation analyst remote capitation payments insurance pcp analysis medical healthcare analyst data financial

We are hospitals and affiliated medical groups, working closely together for the benefit of every person who comes to us for care. We build comprehensive networks of quality healthcare services that are designed to offer our patients highly coordinated, personalized care and help them live healthier lives. Through collaboration, we strive to provide all of our patients and medical group members with the quality, affordable healthcare they need and deserve.

The Capitation Analyst role has a Monday - Friday schedule, from 8am - 5pm. The pay is between $68k - $75k/yr and will be a REMOTE position (Please note: it will require onsite training for two weeks in Orange County, first). This is a Direct Hire position.

Requires experience and extensive knowledge in each of the following areas:

  • PCP Payments – Candidate needs to understand how PCP capitation payments are made and also needs to understand payments for Managed Groups for all States.
  • Specialist Capitation Payments – Needs to understand how payments are made and calculated.
  • Capitation Payments – Needs to understand how payments are calculated.

Job Duties:

  • Compiles and organizes capitation payments data for analysis, forecasting and trending purposes. Interprets key capitation data shifts and presents findings in a clear and concise manner in written, visual and/or oral fashion to Senior Analyst or Supervisor
  • Responsible for the monthly maintenance and data integrity of the capitation. On-going testing, validation, monitoring and financial reporting of the capitation module with continued efforts relating to processes improvement. Assures timely and accurate monthly capitation payments. Appropriate recommendations are required
  • Creates monthly, quarterly, and annual PCP and Specialist payments report for internal review. Develops new, routine and ad hoc reports for Providers and Finance Department for PCP and Specialist Capitation payments. Creates system documentation, including process flow and desk top procedures. Looks for ways to streamline reporting processes
  • Actively participate in supporting internal departments with analysis and reports. Mentors team by providing guidance, support, and assisting with escalated issues and tasks as needed

Qualifications:

  • Minimum Education: Bachelor's degree or equivalent education and experience in Finance or related field preferred.
  • Minimum Experience: Four (4) plus Experience with capitation processing in an HMO managed services organization preferred. Two to Three (2-3) years financial analysis experience in the health care environment preferred.

Benefits:

  • Company 401K
  • Medical, dental, vision insurance
  • Paid time-off
  • Life insurance

Elite Workforce - (323)537-8757

If you have any questions, please give us a call.

Job Type: Full-time

Pay: $68,000.00 - $75,000.00 per year

Benefits:

  • 401(k)
  • Dental insurance
  • Health insurance
  • Life insurance
  • Paid time off
  • Vision insurance

Schedule:

  • 8 hour shift
  • Day shift
  • Monday to Friday

Experience:

  • Capitation Analyst: 4 years (Preferred)
  • Financial analysis: 2 years (Preferred)
  • Healthcare Environment: 2 years (Preferred)

Work Location: One location


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