Responsibilities include, but are not limited to the following:Â
- Performs monthly Incurred But Not Reported (IBNR) liability exposure
- Performs the monthly Risk Share calculation
- Assists in other operational improvement and implementation projects
- Prepare and analyze the quarterly medical expense variance reporting
- Prepare regular and ad-hoc reporting and analysis
- Assist with analytical and data reporting support to internal customers such as Care Management, Claims and Provider partnerships
- Assist with analytical and data reporting support for external entities such as state agencies, commercial accounts, health centers and third party vendors
- Analyze financial impact of hospital and physician contracts
- Assist in the preparation and analysis of the annual medical budget
- Assist in the development and maintenance of provider incentive systems
- Assist in the preparation of work papers for external auditors and actuaries Â
- Participate in the cross-functional team meetingsÂ
- Assist in the preparation and analysis of the monthly financial close
- Assist and maintain provider and hospital fee schedulesÂ
- Identify opportunities for improvement in the department
- Other duties as assigned
- Corporate Compliance Responsibility - As an essential function, responsible for complying with Neighborhood’s Corporate Compliance Program, Standards of Business Conduct, applicable contracts, laws, rules and regulations, policies, and procedures as it applies to individual job duties, the department, and  the Company. This position must exercise due diligence to prevent, detect, and report unlawful and/or unethical conduct by fellow co-workers, professional affiliates and/or agents.
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Core Company-Wide Competencies:
- Communicate Effectively
- Respect Others & Value Diversity
- Analyze Issues & Solve Problems
- Drive for Customer Success
- Manage Performance, Productivity & Results
- Develop Flexibility & Achieve Change
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Job Specific Competencies:
- Collaborate & Foster Teamwork
- Attend to Detail & Improve Quality
- Plan & Organize
- Exercise Sound Judgement & Decision Making
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Grade Level: F
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Neighborhood Health Plan of Rhode Island is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status. Â
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