Analytics & Reporting Consultant - Audit

Health Care Service Corporation • Richardson, TX

262d • $82,700 - $149,300 • Onsite

About The Position

This position is responsible for evaluating accuracy of provider contracts leveraging reports and tools in support of the division; understanding contract terms and how they translate into provider payment; interfacing with contract negotiation team to discuss contract discrepancies; creating specifications for contract audit process enhancements based on business needs; possibly providing consultation to users and leading cross-functional teams to address the enterprise/divisional contract and/or data issues; producing datasets and reports to support contract analysis using system reporting tools; possibly performing research and assisting in analyzing contracts and/or data related to enterprise/divisional strategic initiatives and broader research needs; interfacing between the business and divisional data teams to generate tools to be leveraged in building analysis and reports which are actionable within the business environment; working closely with customers to build relationships; and continuously gaining a deeper understanding of the division's contracts and data in order to meet business needs; analyzing complex business problems and issues using data from internal and external sources to provide insight to decision-makers; identifying and interpreting trends and patterns in contracts and/or datasets to locate influences. This position is responsible for acting as the liaison between business and analytical teams; communicating healthcare payer-based business concepts to analytics users; communicating and marketing the value of analytics outputs to business users in healthcare payer settings.

Requirements

• Bachelor degree and 4 years of analytical experience in relationship management or driving analytics insights into action OR 9 years of analytical experience in relationship management or driving analytics insights into action.
• Experience gathering and documenting business requirements in support of information-related strategies.
• Experience solving complex problems and taking a new perspective using existing solutions.
• Knowledge of various software development processes, including SDLC, Agile methodologies, and tools and technologies.
• Experience creating and conducting presentations to inform and influence.
• Experience in leading functional teams and projects.
• Experience with SAS, SPSS, R, MATLAB, SQL, Python, etc.
• Clear and concise verbal and written communication skills.
• PC proficiency with Microsoft applications including Access, Excel, Word, and PowerPoint.

Nice To Haves

• Understanding of healthcare provider reimbursement methods (e.g., DRG, OPPS, Case Rate, Per Diem, Stop Loss, RVU).
• Experience reviewing and evaluating healthcare provider contracts.
• Knowledge of medical coding process and conventions.
• Bachelor's degree in business, engineering, or mathematics.
• Master's degree.
• Healthcare experience in contract audit, contract negotiation, business analytics, or innovation management.

Responsibilities

• Evaluate accuracy of provider contracts leveraging reports and tools.
• Understand contract terms and how they translate into provider payment.
• Interface with contract negotiation team to discuss contract discrepancies.
• Create specifications for contract audit process enhancements based on business needs.
• Provide consultation to users and lead cross-functional teams to address contract and/or data issues.
• Produce datasets and reports to support contract analysis using system reporting tools.
• Perform research and assist in analyzing contracts and/or data related to strategic initiatives.
• Interface between the business and divisional data teams to generate tools for analysis and reports.
• Work closely with customers to build relationships.
• Analyze complex business problems and issues using data from internal and external sources.
• Identify and interpret trends and patterns in contracts and/or datasets.

Benefits

• Health and wellness benefits.
• 401(k) savings plan.
• Pension plan.
• Paid time off.
• Paid parental leave.
• Disability insurance.
• Supplemental life insurance.
• Employee assistance program.
• Paid holidays.
• Tuition reimbursement.
• Annual incentive bonus plan.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Industry: Insurance Carriers and Related Activities
• Education Level: Bachelor's degree