Job Description
- Job Description:
- Analyze financial, utilization, and performance data to identify opportunities to drive improvements in quality and/or reductions in total cost of care
- Analyze utilization data to reconcile provider disputes
- Design and contribute to the development of the provider reporting packages to help providers understand their overall performance
- Contribute to the development of data models to attribute members to providers for new and enhancements to existing value-based programs and to evaluate program effectiveness
- Perform quality assurance checks with peers and lead Business Intelligence associates to ensure development of the program meets business requirements
- Partner with finance team to conduct impact analysis and modeling for new VBP models
- Collaborate with cross functional and matrixed teams to operationalize and roll out new VBP models
- Monitor VBP model performance KPIs to identify opportunities to enhance model design based on internal and external feedback and performance data
- Design and develop Return on Investment (ROI) Analyses for new Value Based Payments (VBP) using multiple data sources, including prior authorizations, healthcare claims, Admit/Discharge/Transfer (ADT) data, HEDIS data, etc.
- Ensure data integrity in program administration for new value-based programs
- Troubleshoot data integrity issues and offer solutions to solve challenges
- Requirements:
- Bachelor's degree
- 5 or more years of technical experience in data analysis OR Master's degree and 3 or more years of experience in data analysis
- Advanced in SQL, SAS and other data systems
- Experience with tools such as Power BI and DAX language for creating data visualizations
- Proficiency in verbal and written communication to senior and executive leadership
- Advanced experience working with big and complex data sets within large organizations
- Experience analyzing data to solve a wide variety of business problems and create data visualizations that drive strategic direction
- Comprehensive knowledge of Microsoft Office Applications including Word, Excel, Access and PowerPoint
- Strong organizational skills and ability to manage multiple or competing priorities
- Proficiency in understanding Healthcare related data
- Must be passionate about contributing to an organization focused on continuously improving consumer experiences
- Strong attention to detail
- Benefits:
- Health benefits effective day 1
- Paid time off, holidays, volunteer time and jury duty pay
- Recognition pay
- 401(k) retirement savings plan with employer match
- Tuition assistance
- Scholarships for eligible dependents
- Parental and caregiver leave
- Employee charity matching program
- Network Resource Groups (NRGs)
- Career development opportunities
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