Financial Analyst, Managed Care
Independent Living Systems
Benefits
Job Type
Description
We are seeking a Financial Analyst, Managed Care to join our team at Independent Living Systems (ILS). ILS, along with its affiliated health plans known as Florida Community Care and Florida Complete Care, is committed to promoting a higher quality of life and maximizing independence for all vulnerable populations.
About the Role:
The Financial Analyst, Managed Care is primarily responsible for the accurate preparation, analysis, and administration of monthly capitation payments to provider partners. In addition to capitation-focused responsibilities, the role may also support traditional financial analyst functions such as financial analysis, reporting, reconciliations, and variance analysis to support broader finance and operational initiatives. This role works closely with cross-functional teams to ensure payments are timely, contractually accurate, and supported by underlying enrollment and encounter activity. The Financial Analyst, Managed Care also monitors payment trends, identifies anomalies or variances, and conducts detailed investigations to resolve issues and mitigate financial risk.
Minimum Qualifications:
- Bachelor’s degree in Finance, Accounting, Economics, Healthcare Administration, or a related field.
- 2 years of experience in financial analysis, preferably within the healthcare or managed care industry.
- Strong analytical skills with the ability to identify trends, outliers, and data inconsistencies.
- Excellent attention to detail and ability to work with large, complex data sets Advanced proficiency in Excel (pivot tables, lookups, formulas); experience with databases or reporting tools preferred.
- Strong communication skills and ability to partner effectively with cross‑functional teams.
- Relevant experience may substitute for educational requirement on a year-for-year basis.
Preferred Qualifications:
- Experience working with Medicaid, Medicare Advantage, or other managed care programs.
- SQL, Power BI, Tableau, or other analytics tool experience a plus.
- Solid understanding of capitation models, provider contracts, and healthcare payment structures.
- Familiarity with eligibility files, encounter data, and payment reconciliation.
- Experience supporting audits or regulatory reporting.
Responsibilities:
- Demonstrate commitment to Our Mission and models ILS Experience Standards of Excellence.
- Prepare, validate, and process monthly capitation payments, reconciling calculations to enrollment, eligibility, and encounter data in accordance with contractual deadlines.
- Partner with finance and operational teams to resolve payment inquiries, discrepancies, and communicate payment methodology or adjustments.
- Monitor capitation payments for anomalies, unusual trends, or variances; investigate root causes and recommend corrective actions.
- Perform financial analysis, reconciliations, and variance analysis related to provider payments, medical expense, and managed care metrics.
- Support contract changes, audits, reporting requests, and collaborate with IT, Encounter/Data teams, and Finance while maintaining payment documentation.
- Perform other duties as assigned.
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Skills
About Independent Living Systems
Independent Living Systems (ILS) is a health-services company that delivers turn-key solutions to millions of America’s frail, special needs, and aging population, offering clinical and third-party administrative services to managed care organizations.