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Provide strategic analysis that impacts business decisions, improves efficiency and drives innovation. Perform data extraction, healthcare cost analysis, analytical model development, as well as production of various reports to support corporate strategies and initiatives. Execute complex analyses that guide the development of reimbursement policy, provider negotiations, network development, value-based care, population health management, utilization management programs and other medical cost containment solutions.
Job Responsibility
Provide strategic analysis that impacts business decisions, improves efficiency and drives innovation
Perform data extraction, healthcare cost analysis, analytical model development, as well as production of various reports to support corporate strategies and initiatives
Execute complex analyses that guide the development of reimbursement policy, provider negotiations, network development, value-based care, population health management, utilization management programs and other medical cost containment solutions
Provide accurate, timely and reliable delivery of data, metrics, reporting and analysis in support of multiple strategic goals, mandates, and legislation
Develop processes, write programs and/or create databases using analytic tools to produce accurate and timely completion of analytic solutions
Identify, analyze, interpret and validate healthcare data metrics, trends and patterns
Develop and analyze business performance reports (e.g. for claims data, provider data, utilization data) and provide notations of performance deviations and anomalies
Model financial impact analyses for a variety of business initiatives
Partner with peers to establish, evaluate, and continually improve measurement methodologies, while adhering to nationally accepted analytic and reporting standards
Act as liaison to both internal business partners and external providers or vendors
Create, modify, maintain, and enhance existing programming or business processes associated with specific responsibilities
Interpret, communicate, and present results to all levels of management in consistent and easy to understand formats to facilitate fact-based decision-making
Complete projects within preset timelines and report status to supervisor and project manager
Prepare written documentation on projects to provide a peer review trail and ensure continuity and integrity
Build and maintain close working relationships with internal stakeholders and key external client contacts (e.g. Providers, Internal Clinicians, Vendors, Customers, Brokers, BCBS Association, Blues Plans, Auditors)
Requirements
Bachelor's Degree in mathematics, statistics, business, or related field of study
1 year of experience in data analysis using analytic tools and processes (Level 1)
3 years of experience in data analysis using analytic tools and processes (Level 2)
3 years of experience working for a healthcare organization/heath insurer in data analysis using analytic tools and processes using advanced SAS procedures and/or data mining (Level 3)
5 years of experience working for a healthcare organization/heath insurer in data analysis using analytic tools and processes using advanced SAS procedures and/or data mining (Level 4)
Nice to have
1 year of experience in data analysis working for a healthcare organization / health insurer (Level 1)
3 years of experience working for a healthcare organization / health insurer, including development of business analytics and financial impact analyses (Level 2)
5 years of experience working for a healthcare organization / health insurer, including development of business analytics and financial impact analyses (Levels 3, 4)
Master’s Degree in mathematics, statistics, business, or related field of study
Advanced proficiency in spreadsheet, database and word processing software
Intermediate proficiency with data warehouses and query tools / design
Intermediate skill with data visualization tools, such as Tableau
Intermediate proficiency with development, testing, and management of Tableau Dashboards
Intermediate understanding of data management principles
Advanced skill in database, spreadsheet, business intelligence, statistical, and data cubing software
Familiarity with provider network design processes and strategies
Knowledge of health benefit design and rating techniques
Advanced skills in mathematics and statistics
Proficiency in SAS Enterprise Business Intelligence software
Advanced understanding of data management principles
Project management skill needed to create timelines, track deliverables and progress, resolve issues, and communicate project status
Ability to engage and collaborate with team members and business stakeholders at all levels of the organization
Ability to make decisions in a timely manner, sometimes with incomplete information and under tight deadlines
High standard of performance while pursuing aggressive goals