Financial Analyst at High Desert Pace Inc – Victorville, California

Reporting to the Director of Quality and Compliance, The Finance Analyst is a key member of the finance team responsible for the accurate recording, reconciliation, and reporting of all revenue and expense activity in support of High Desert PACE’s capitated payment model. This role ensures timely and compliant financial entries, manages critical healthcare-specific accruals and estimates (including IBNR), supports regulatory submissions to CMS and DHCS, assists with the annual Part D bid process and program oversight, and collaborates across departments to maintain strong financial controls and budgeting processes.

Training Development and Delivery

• Enter Medicare and Medi-Cal accrual entries into accounting system to properly recognize capitated revenue and related expenses in accordance with CMS and DHCS guidelines.
• Prepare the Incurred but Not Received (IBNR) file for the actuary, submit it timely, and enter the final IBNR journal entry received from the actuary into accounting system to accurately reflect medical claims liabilities.
• Prepare and enter bi-weekly payroll journal entries using data extracted from payroll system.
• Complete DHCS Monthly Financial Preparation and DHCS Quarterly Financial Preparation, including all required schedules and supporting documentation.
• Attend actuarial webinars and related training in preparation for the Annual Part D Bid Process.
• Review monthly PDE (Prescription Drug Event) return files, identify and correct rejections, and ensure accurate and complete submissions to CMS.
• Prepare and enter the monthly company credit card journal entry.
• Resolve finance-related customer service issues for participants, providers, and internal stakeholders.
• Perform Medicare/Medi-Cal Payment Review & AR Management, including follow-up on outstanding receivables.
• Conduct RAPS/EDS File Review to support accurate Medicare risk-adjustment data and payment integrity.
• Review monthly files from the PBM and reconcile pharmacy benefit costs.
• Work directly with DHCS on outstanding AR to facilitate timely resolution and collections.
• Prepare annual budget files and collaborate with department directors to develop, review, and finalize departmental budgets.

Continuous Improvement

• Stay current with regulatory requirements
• Participate in user groups, webinars, and vendor training opportunities
• Identify opportunities to optimize workflows and improve system utilization
• Gather feedback from staff to continuously improve training programs and materials

General

• Participating in staff meetings, trainings, assigned projects, and committees
• Complying with all organizational policies, procedures, and scheduling requirements
• Performing all other duties as assigned in a cooperative and flexible manner
• Being available for flexible scheduling, including varying hours as needed
• Utilizing a personal vehicle when required for work-related tasks

Skills & Abilities

• Work independently and as an effective member of a team.
• Establish and maintain effective interpersonal relationships with all levels of staff, other programs, agencies, members, providers and the public.
• Communicate effectively, both verbally and in writing, with individuals from varying cultural backgrounds.
• Prepare concise and clear reports.
• Effectively utilize computer and appropriate software and interact as needed with High Desert PACE Information Systems.
• Foster and model an effective team environment, where each team member is held accountable for their independent work.
• Approach leadership with an openness to new ideas, cultural humility and acknowledgment of the dynamics of privilege.

Knowledge of

• Techniques of financial forecasting & planning, quality, and research methods.
• Principles and practices of health care, health care systems, and managed care
• Medicare and Medi-Cal benefits and regulations
• Community-based organizations, agencies, and community services
• Team and value-based care
• Regulatory policies, rules, and regulations

Education & Training

• Bachelor’s degree in finance or business (or related degree)
• Minimum two years’ experience working in the finance of healthcare services or insurance products.