Benefit Management Analyst I

SKYGEN • United States,

7d • $55,014 - $82,522 • Remote

About The Position

The Benefit Management Analyst I supports the analysis and monitoring of provider behavior to promote appropriate care to members while controlling costs for our clients, measuring provider data and maintains appropriate documentation for tracking activity and results for the department. Collaborates with other areas including client experience team, clinical, provider relations and developers.

Requirements

• SQL experience is required.
• Associates Degree/Two Year Degree in math/stats/finance/accounting or a related field of study is required.
• 1-3 years of job related experience
• Intermediate knowledge of Excel, Word and PowerPoint.
• Intermediate knowledge of email.
• Able to remain organized with multiple interruptions.
• High attention to detail.
• Analytical skills that assist in ability to solve routine problems.
• Excellent time management skills.
• Good oral communication skills.
• Ability to work well with a variety of individuals.
• Ability to work well independently.

Nice To Haves

• Familiarity with Power BI is preferred but not mandatory.
• Bachelor’s degree in math/stats/finance/accounting or a related field of study is preferred.

Responsibilities

• Maintain all internal information in an organized manner, document and track results of all departmental activity.
• Analyze provider data to identify outlier provider performance. Provide in-depth analysis of data/provider payments to determine potential outliers or data trends. Assist with identifying root cause issue and communicate findings to appropriate staff.
• Ensure all cases are properly documented for reference and review.
• Develop and recommend action plans for enhancing benefit outcomes to members while controlling costs.
• Develop and maintain processes and all relevant documentation used to take corrective actions with providers.
• Follow company guidelines for changing provider behavior and/or removing outlier providers, when abnormal behavior is identified.
• Create and regularly review standard benchmarks for each market regarding network performance.
• Coordinate targeted provider’s random chart audits to ensure standards are met and appropriate peer committee reviews.
• Utilize internal systems to generate information and analyze using system reports.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: Associate degree