Medicaid Financial Analyst

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 PHP's 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 PHP. Problem 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.

• 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

• 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.

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 activities-like challenges, webinars, and screenings-with 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 14,000 employees, it is the largest private employer in the state, serving over 580,000 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.