Lead Decision Support (Principal Financial Analyst)
HybridMedicaidMedicare AdvantagePricing & RatingPredictive Modelling & MLBusiness Intelligence & Reporting
Role Summary
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Senior health-plan financial analyst (Lead Decision Support) based in Orange, CA with partial telework in California. Acts as a subject-matter expert on Medi‑Cal and Medicare Advantage finance, provider rate methodology, and provider contract modeling. Owns medical cost projections, develops financial models for contract negotiations, and builds dashboards from claims and enrollment data.
JOB DESCRIPTION SUMMARY
- Lead financial analyses for a California Medicaid/Medicare health plan
- Develop medical expense, revenue and enrollment projections
- Model provider contracts and support negotiations
- Build dashboards and reports using Excel, Tableau and SQL
- Partial telework in California; at least 2 days/week in Orange, CA office
DOMAIN EXPERTISE
- Managed care financial analysis
- Provider contract modeling and provider rate analysis
- Provider reimbursement pricing and managed care contracting
KEY REQUIREMENTS
- Bachelor's degree in finance, economics, actuarial sciences or related field
- 6+ years of financial analysis experience in managed care required
- 3+ years provider contract modeling, rate analysis, or managed care contracting
- Experience working with large claims, enrollment and provider data
TECH STACK
- Excel
- Tableau
- PowerPoint