Financial Analyst I - Prospect Medical Holdings, Inc.

The Financial Analyst I works independently to create timely and actionable information used to improve outcomes, clinical quality management, health management and financial auditing based on clinical and financial data. The Financial Analyst I is expected to independently function at a high level of technical and mathematical proficiency, using sophisticated data mining tools, multi-dimensional databases, and best practices to resolve complex issues encountered in accessing, converting, accumulating and processing clinical and administrative data from a wide variety of sources and formats. The Financial Analyst I will make key decisions to maintain continuous quality improvement process, and become a subject matter expert of current medical terminology, billing and coding standards, technology tools and industry best practices.With approximately 9,000 physicians to serve our 260,000 members, Prospect Medical Systems is proud to be among the most innovative medical systems in California, Texas and Rhode Island. Our extensive care services range from primary care and specialty physician services to acute care hospital and skilled nursing facilities to behavioral health and wellness services. Each of our Independent Physician Associations (IPAs) and networks support the use of advanced diagnostic and treatment tools to provide our members with convenient access to state-of-the-art healthcare. For 25+ years, Prospect Medical has been focused on our mission of supporting independent physicians where, through risk arrangements, we work closely together with health plans, facilities and healthcare physicians for the benefit of every person who comes to us for care. We provide quality healthcare services that are designed to offer our patients highly coordinated, personalized care and that help them live healthier lives. Prospect Medical Systems manages highly successful IPAs by leveraging our best-practices, results-driven administrative services to manage patients under risk arrangements with health plans/CMS.Minimum of one (1) years related experience in analytic programming, data extraction, querying databases/data warehouses and data analysis using SQL or an equivalent software product and/or training.High school diploma or GEDBachelor's degree from four-year college or university in statistics, mathematics, computer science or related discipline and/or equivalent training preferred.

• Independently compiles and conducts ongoing analysis and evaluation of claims, revenue, eligibility, expense, and clinical data for forecasting and trending purposes. Identify and interpret trends or patterns in complex data sets. Present findings in a clear, concise manner.
• Develops appropriate recommendations and suggestions based on findings and collaborates with management in the development of action plans where required. Locate and define new process improvement opportunities.
• Creates, develops, analyzes and monitors new, routine and ad hoc reports for company-wide use.
• Strategically plans and makes logical, thoughtful, independent decisions regarding projects. Completely understands the source files used in the creation of meaningful reports via Excel, Access, and SQL. Codes algorithms based on complex methodology.
• Provides statistical and financial data files and reports as requested and plans time appropriately to allow for quality checks and variance analysis.
• Acquires data from primary or secondary data sources and maintains databases.

• Independently compiles and conducts ongoing analysis and evaluation of claims, revenue, eligibility, expense, and clinical data for forecasting and trending purposes. Identify and interpret trends or patterns in complex data sets. Present findings in a clear, concise manner.
• Develops appropriate recommendations and suggestions based on findings and collaborates with management in the development of action plans where required. Locate and define new process improvement opportunities.
• Creates, develops, analyzes and monitors new, routine and ad hoc reports for company-wide use.
• Strategically plans and makes logical, thoughtful, independent decisions regarding projects. Completely understands the source files used in the creation of meaningful reports via Excel, Access, and SQL. Codes algorithms based on complex methodology.
• Provides statistical and financial data files and reports as requested and plans time appropriately to allow for quality checks and variance analysis.
• Acquires data from primary or secondary data sources and maintains databases.