Position 2: Sr. Healthcare Informatics Analyst (Medicare Advantage)
Seeking a Senior Healthcare Informatics Analyst! The selected candidate will independently provide analytics in understanding and improving how health care is valued, utilized and provided. This position will develop analytic attributes that pertain to patient level health utilization/outcome, provider performance measures, risk-adjusted revenue optimization, medical cost management, and behavior attributes on patient/provider engagement. In collaboration with other business areas and IT, this position leads in problem solving, solution development and strategic planning and decision making. Accountable for complying with all laws and regulations associated with duties and responsibilities.
POSITION PURPOSE
The Senior Healthcare Informatics Analyst independently provides analytics in understanding and improving how health care is valued, utilized and provided. This position will develop analytic attributes that pertain to patient level health utilization/outcome, provider performance measures, risk-adjusted revenue optimization, medical cost management, and behavior attributes on patient/provider engagement. In collaboration with other business areas and IT, this position leads in problem solving, solution development and strategic planning and decision making. Accountable for complying with all laws and regulations associated with duties and responsibilities.
<>Required Skills
- Healthcare experience is a must; Medicare Advantage trend analysis required.
- Education: Bachelor''''''''s in healthcare administration, statistics, economics, analytics, computer science required. Master''''''''s in related field preferred. Four years of related experience can be used in lieu of a Bachelor-s degree.
- 4 years of health care, analytics, IT or management consulting experience.
- Strong critical thinking, analytical and problem-solving skills are required.
- Requires experience building predictive models.
- Strong knowledge of outcome research design, controlled study design is preferred.
- Advanced knowledge of SAS including Enterprise Miner is preferred.
Basic knowledge of United States healthcare delivery system in payer setting or provider setting is required.
- Must have strong knowledge of common query/analytic/visualization tools such as SQL, SAS, R, Python, Tableau, etc.
- Strong understanding of provider payment methodologies, population health management, and risk adjustments is desired.
- Strong understanding of clinical groupers including episode groupers and risk groupers such as DRG, APC, ETG, MEG, DxCg, and HCC is highly desired. Strong understanding of quality metrics (HEDIS, AHRQ) is desired.
- Knowledge of commercial risk optimization and MA risk optimization is a plus
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