Medicaid Financial Analyst
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Job Location:
Albuquerque, NM - USA
Monthly Salary:
Not Disclosed
Posted on:
23-08-2025
Vacancies:
1 Vacancy
Job Summary
Overview
Presbyterian is seeking a Medicaid Financial Analyst.
The Medicaid Financial Analyst serves as key individual contributor to review and analyze directives from the New Mexico Health Care Authority (HCA) for PHPs Medicaid program to ensure financial compliance review the adequacy of funding for each directive support provider rate implementations and perform provider rate reconciliations. This role will partner with multiple business areas within the health plan to ensure directive compliance and optimal financial performance.
Lead sessions for strategic and operational planning and implement outcome of plans and directives.
This role will be involved in meetings where decisions are made and presentations are required for senior leadership the Board of Directors and/or other organizations within solver for urgent financial issues impacting the organization.
- This is a Full Time position - Exempt: Yes
- Job is based at Rev Hugh Cooper Admin Center
- Work hours: Days
- Remote: Open to remote applicants in the United States except for the following states: California Illinois North Dakota New York Ohio Washington and Wyoming
Prefer Qualifications:
- Must have a CPA License and/or Masters degree.
- Experience dealing with highly confidential information.
- Interfaces with all levels of the organization including the CEO.
- Combination of technical financial and business knowledge and experience.
Qualifications
- Bachelors degree in finance accounting.
- Four years of health care finance experience or equivalent work experience.
- Intermediate to expert MS Office skills with focus on PowerPoint and Excel
- Business acumen to handle both complex situations and multiple responsibilities simultaneously
Responsibilities
Review New Mexico HCA directives to assess financial impact and funding adequacy.
Collaborate with Medical Economics to ensure proper financial alignment with each directive.
Implement provider rate changes accurately including CPT and revenue code updates.
Audit finalized rates to confirm correct provider payments and prevent over/underpayments.
Reconcile provider rates in the claims system with HCA Medicaid Floor Rates and agreements.
Respond to HCA draft directives with feedback or recommended corrections.
Lead financial projects manage timelines and support senior-level planning and communication.
Provide strategic financial analysis for initiatives beyond routine operations.
Prepare reports presentations and messaging; represent Finance leadership as needed.
Support finance technology development including data-marts and reporting tools.
Benefits
About Presbyterian Healthcare Services
Presbyterian offers a comprehensive benefits package to eligible employees including medical dental vision disability coverage life insurance and optional voluntary benefits.
The Employee Wellness Rewards Program encourages staff to engage in health-enhancing activitieslike challenges webinars and screeningswith opportunities to earn gift cards and other incentives.
As a mission-driven organization Presbyterian is deeply committed to improving community health across New Mexico through initiatives like growers markets and local partnerships.
Founded in 1908 Presbyterian is a locally owned not-for-profit healthcare system with nine hospitals a statewide health plan and a growing multi-specialty medical group. With nearly 14000 employees it is the largest private employer in the state serving over 580000 health plan members through Medicare Advantage Medicaid and Commercial plans.
AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.
Maximum Offer for this position is up to
Compensation Disclaimer
Required Experience:
IC
Key Skills
- Cognos
- Forecasting
- Hyperion
- Microsoft Access
- Pivot tables
- Accounting
- Analysis Skills
- Microsoft Excel
- Financial Analysis
- Financial Modeling
- Budgeting
- Financial Planning
About Company
Find the medical care and health plan you and your family need at Presbyterian Healthcare Services, an integrated system of hospitals, healthcare providers and insurance plans serving patients and members in New Mexico.
