This position provides analytical, research, reporting, and technical support by mining, extracting and utilizing appropriate data from source systems and data warehouse through analytic reports on a regular and ad-hoc basis that assist in identifying, but not limited to, clinical outcomes, revenue opportunities, quality of care issues, tracking specified conditions that assist in the clinical management of patients, supporting quality improvement projects and initiatives, identifying and measuring outcomes of programmatic interventions inclusive of financial analyses.
ESSENTIAL DUTIES AND RESPONSIBILITIES
- Perform statistical population health utilization, cost and quality analytics to develop total cost of care targets for at-risk populations.
- Support and inform clinical, network and efficiency improvement initiatives through complex analytics and financial modeling.
- Performing analytics to support provider benchmarking and high performance network development and management.
- Responsible for source system data analyses, identification of business rules and data elements for data transformation/migration into the data warehouse. Assists with data sharing and reconciliation among the various data systems as well as developing methods for standardizing data collection, database design, validation reports and analysis.
- Perform special analysis on utilization and/or cost reports, revenue data, and risk scores.
- Track issues with reports, including defects in object logic, schema logic, data quality problems and process errors. Understand complete reporting lifecycle to diagnose problems.
- Utilize tools for monitoring quality of data and assists in development of corrective action plans when issues are discovered.
- Support creation of Data Warehouse and other analytical tools
- Responsible for participating and contributing in cross functional projects.
- Perform all other related duties as assigned.
- Bachelor's degree in Healthcare, Business, Information Technology or related field preferred
- Understanding of Health Plans/Clinic Operations/Medicare/Medicaid/HEDIS/HCC
- 2+ years of health care experience required, preferably managed care
- 2+ years of hands on SQL programming experience
- Advanced level of proficiency with MS Access, Excel and other office suites.
- Strong written and verbal communication
- Demonstrated ability to communicate ideas clearly and concisely
- Excellent time management, organizational, and prioritization skills and ability to balance multiple priorities
Job Type: Full-time
Salary: $93,000.00 /year
- SQL: 2 years (Required)
- HEDIS: 1 year (Required)
- health plan: 2 years (Required)