Senior Financial Analyst - Redwood Coast PACE

JOB SUMMARY:

The Senior Financial Analyst supports the financial operations, regulatory reporting, and analytical functions of the Redwood Coast PACE program. Under the direction of the Director of Finance, this role is responsible for financial forecasting, operational analysis, healthcare claims oversight, regulatory reporting, budgeting support, and strategic financial planning activities that support organizational sustainability and compliance.
This position works collaboratively with executive leadership, operational teams, third-party vendors, and regulatory agencies to provide data-driven insights and ensure the effective financial management of the PACE program.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

1. Prepare and analyze financial, operational, and utilization reports for executive leadership and program management.
2. Support financial planning activities including budgeting, forecasting, trend analysis, and long-range financial modeling.
3. Conduct financial and operational analysis related to PACE program initiatives, reimbursement, and performance improvement opportunities.
4. Coordinate and support CMS, DHCS, and HPMS reporting requirements, including Part D reconciliations and DIR reporting.
5. Manage and coordinate the annual Milliman Part D Bid process and DHCS annual rate development submissions.
6. Prepare quarterly financial reports, forecasts, and other required regulatory filings.
7. Oversee enrollment and disenrollment financial processes including enrollment files, payment reconciliation, and premium tracking.
8. Serve as the internal lead for claims management activities in collaboration with the Third-Party Administrator.
9. Support management of pharmacy benefit manager financial operations including invoice review, payment processing, coding, and reconciliation activities.
10. Prepare and distribute monthly benchmarking and KPI reporting to leadership and operational teams.
11. Participate in industry and regulatory meetings with organizations such as CalPACE and NPA and provide summaries and recommendations to leadership.
12. Assist with month-end close processes including claims accrual preparation and journal entry support.
13. Support annual audits and program-specific financial reviews conducted by internal and external auditors.
14. Collaborate cross-functionally with operational and clinical teams to support program goals and organizational initiatives.
15. Additional duties may be assigned, as needed, that align with the responsibilities of the position and support the vision, mission, and values of the organization.

EDUCATION &/or EXPERIENCE:

1. Bachelor’s degree in Finance, Accounting, Business Administration, Healthcare Administration, or related field. Equivalent combination of education and relevant experience may be considered.
2. Minimum of 2 to 5 years of experience in financial analysis, accounting, healthcare finance, reimbursement, or operational finance.
3. Experience working in a regulated environment with responsibility for reporting, reconciliation, analysis, or budgeting.
4. Intermediate to advanced Microsoft Excel skills, including data analysis and reporting functions.

Preferred Qualifications

1. Experience with Medicare, Medi-Cal, managed care, or healthcare reimbursement models strongly preferred.
2. Experience in a healthcare, nonprofit, government-funded, or insurance-related environment preferred.
3. Familiarity with claims processing, enrollment reconciliation, or healthcare operational reporting preferred.
4. Experience with CMS, DHCS, HPMS, or other healthcare regulatory reporting systems preferred.
5. Experience with Electronic Health Record (EHR) systems and accounting software platforms preferred.

Equivalent Experience Consideration

1. Candidates with strong analytical skills and transferable healthcare finance or reimbursement experience who may not meet all preferred qualifications are encouraged to apply.

PRE-SCREENING REQUIREMENTS:

1. Requires clearance of a DOJ and FBI criminal history background check.

JOB SKILLS/KNOWLEDGE:

1. Demonstrates advanced decision-making and sound professional judgment in evaluating complex financial, operational, and strategic issues with minimal supervision.
2. Analyzes and interprets complex data sets to develop strategic, actionable recommendations that support organizational goals, financial performance, and operational effectiveness.
3. Ability to prioritize and meet a high number of reporting and accounting deadlines.
4. Demonstrates knowledge of financial skills through accounting, budget development, and an aptitude to create a variety of analytical reports and perform internal audits.
5. Ability and technical skills to review, accurately analyze, prepare, and make recommendations regarding financial reports.
6. Proficiency in understanding healthcare-related data and CMS regulations.
7. Experience in developing and tracking Key Performance Indicators.
8. Proven experience and advanced knowledge of computer software programs, including Microsoft Office, various accounting software platforms and web-based applications.
9. Strong verbal and written communication abilities; able to convey information clearly and professionally to staff, participants, families, and external partners.
10.  Works effectively as part of a multidisciplinary team demonstrating sound listening skills to receive directions and understand concerns; maintains a cooperative and supportive attitude.
11. Maintains confidentiality, reliability, and ethical standards; consistently demonstrates punctuality, attendance, and responsibility in work performance.
12. Maintains participant privacy and organizational confidentiality, adhering to HIPAA and agency standards.
13. Remains calm and effective when priorities shift, deadlines change, and unexpected issues arise.
14. Ability to be dependable, accept supervision, follow direction, and improve performance through feedback.

SUPERVISORY REQUIREMENTS:

1. This position does not directly supervisor staff.

PHYSICAL REQUIREMENTS:

This position is primarily sedentary and performed in a standard office or remote work environment. The role requires prolonged periods of sitting, working at a computer, and frequent use of hands and fingers for typing, data entry, and operating standard office equipment such as a computer, calculator, and telephone. The incumbent must be able to read and interpret detailed information on computer screens and in printed materials, and communicate effectively both verbally and in writing. Occasional standing, walking, bending, and reaching may be required. The ability to lift and carry up to 10 pounds (e.g., files, reports, or office supplies) may be necessary on an infrequent basis.

The above statements are intended to describe the general nature of work performed.  They are not to be considered an exhaustive list of all job tasks performed.  The agency reserves the right to change job descriptions, work hours or work sites as required by the program.

The Humboldt Senior Resource Center is a private, non-profit, multi-purpose senior center providing a continuum of social and health related services. The agency currently holds contracts with the California Department of Aging and Area 1 Agency on Aging.

The Humboldt Senior Resource Center is an equal opportunity employer.  We will not unlawfully discriminate against qualified applicants or employees with respect to any terms or conditions of employment based on race, color, national origin, ancestry, sex, sexual orientation, age, religion, physical or mental disability, medical condition, pregnancy, breastfeeding, gender identity, marital status, citizenship status, military or veteran status, genetic information, or other basis protected by applicable federal or state law.