Utilization Management Data Analyst

Care1st Health Plan - Monterey Park, CA (30+ days ago)3.3


GENERAL SUMMARY:

Under the direction of the VP of Medical Services the UM Data Analyst is responsible for supporting the UM Department Management Team in the analysis of UM Department Activities. This position involves working and analyzing the functionality of Access databases and will act as a liaison between the MIS Department, Senior Data Analysts, and the UM Department.

The incumbent must be proficient in collecting, managing, assuring data quality, and reporting of all data relevant to Medical Management programs at Care1st.

QUALIFICATIONS: **

  • Excellent analytical skills
  • Must have understanding of Excel, Access and database development
  • Must have proficient skills with Microsoft Office Suite
  • Ability to create spreadsheets, correlate data into graphs
  • Able to identify data discrepancies
  • Excellent verbal and written communication skills
  • Medical terminology highly desirable
  • Ability to deliver reports timely and in accordance with formatting specifications

ESSENTIAL DUTIES AND RESPONSIBILITIES:

  • Prepares UM Data reports for MSC and BOD meetings.
  • Prepares quarterly and annual ICE reports for L.A. Care Health Plan.
  • Develops and coordinates utilization management reports.
  • Provides in-house user and training assistance when required.
  • Assist in issue resolution as it pertains to UM reports.
  • Prepares UM correspondence for over-site entities as it relates to UM data reports.
  • Attends UM meetings as appropriate for the planning and development of UM Data reports.
  • Reviews and organizes data management of databases.
  • Generates CCMS Reports and acts as a back-up administrator of CCMS.
  • Coordinates reporting and validation of Part C Organization Determinations.
  • Other related duties as assigned.

Job Type: Full-time

Experience:

  • Analytics: 4 years
  • Healthcare, Healthplan, Managed Care or Medical Group: 4 years

Education:

  • High school