Position Purpose: Analyze integrated and extensive datasets to extract value, which directly impacts and influences business decisions. Work collaboratively with key business stakeholders to identify areas of value, develop solutions, and deliver insights to reduce overall cost of care for members and improve their clinical outcomes. Interpret and analyze data from multiple sources including claims, provider, member, and encounters data. Identify and assess the business impact of trends Develop, maintain, and troubleshoot complex scripts and reports developed using SQL, Microsoft Excel, or other analytics tools Contribute to the planning and execution of large-scale projects with limited direction from leadership Assist in the design, testing, and implementation of process enhancements and identify opportunities for automation Identify and perform root-cause analysis of data irregularities and present findings and proposed solutions to leadership and/or customers Manage multiple, variable tasks and data review processes with limited supervision within targeted timelines and thrive in a demanding, quickly changing environment
Education/Experience: Bachelor s degree in business, economics, statistics, mathematics, actuarial science, public health, health informatics, healthcare administration, finance or related field or equivalent experience. Master's degree preferred. 4+ years of experience working with large databases, data verification, and data management or 2+ years of IT experience. Healthcare analytics experience preferred. Working knowledge of SQL/querying languages. Preferred knowledge of programmatic coding languages such as Python and R. Knowledge of statistical, analytical, or data mining techniques including basic data modeling, trend analysis, and root-cause analysis preferred. Preferred knowledge of modern business intelligence and visualization tools including Microsoft PowerBI. Experience in emerging trend analysis, financial modeling, claims pricing, contract/network analysis, and/or ROI evaluation preferred. Familiarity with claims payment, utilization management, provider/vendor contracts, risk adjustment for government sponsored healthcare desired.
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