Senior Rate Development Analyst
General Statement of Duties
This position is responsible for leading the rate development process for CareOregon and its Coordinated Care Organizations (CCOs). This includes co-leading the Medicare bid development process, developing Medicare financial forecasts and serving as the financial representative on the Medicare team.
Essential Position Functions
• Lead the rate development process for CareOregon and its CCOs.
• Work with the CEOs and financial personnel of each CCO and the Metro region to communicate rate updates and their implications
• Coordinate with the internal behavioral health, dental and NEMT leaders, and other external related organizations to ensure a complete submission of cost data to the State.
• Work with outside actuaries and the State’s Office of Actuarial and Financial Analytics team to ensure fair rates.
• Serve as one of the primary financial liaisons between CareOregon, its CCOs and the State’s Office of Actuarial and Financial Analytics.
• Work closely with HealthShare’s staff and external actuaries to ensure fair rates for CareOregon and all HealthShare partners.
• Work closely with the Financial Planning and Analysis Manager and other Finance and in-house actuarial staff to ensure rate updates are communicated timely.
• Hand-off rates information to the Information Services department for 820 programming
• Forecast OHP membership for each of the CareOregon CCO’s,
• Co-lead the Medicare bid development process.
• Develop the Medicare administrative bid components.
• Prepare periodic Medicare financial forecasts and advise management on its implications
• Serve as the financial representative on the Medicare team.
• Assist in the reinsurance processes and RFPs as needed.
• Prepare reports, updates and presentations as requested.
Knowledge, Skills and Abilities Required
• Strong understanding of rate development methodologies and practices
• Knowledge of Generally Accepted Accounting Principles
• Understanding of medical costs and trends
• Understanding of the Medicaid and Medicare business
• Understanding of the Medicaid and Medicare rate setting process
• Advanced spreadsheet and data analysis skills
• Intermediate word processing skills
• Excellent written and verbal communication skills
• Ability to effectively collaborate with multiple stakeholders
• Ability to manage multiple tasks
• Ability to problem solve, analyze and provide written documentation of analysis
• Ability to communicate project status and issues to manager timely
• Ability to work in an environment with diverse individuals and groups
Education and/or Experience
• Minimum 6 years’ financial analysis and/or accounting experience, including minimum 3 years’ experience in rate development
• Rate development experience in Healthcare, Medicare and Medicaid
• Bachelor’s degree in Accounting, Finance, Healthcare Administration, or related field
Candidates of color are strongly encouraged to apply. CareOregon is committed to building a linguistically and culturally diverse and inclusive work environment
Veterans are strongly encouraged to apply.
Equal opportunity employer. This company considers all candidates regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.