Benefit Management Analyst I

SKYGEN•Menomonee Falls, WI

7d•Remote

About The Position

The Benefit Management Analyst I supports analysis and monitoring of provider behavior to promote appropriate care for members while controlling costs for clients. The role measures provider data and maintains documentation to track departmental activity and results. It collaborates with the client experience, clinical, provider relations, and development teams. This is a permanently remote position with flexible daytime hours Monday through Friday. Availability from 9:00 AM to 3:00 PM CST is required, with flexibility around those hours. SQL experience is required; familiarity with Power BI is preferred but not mandatory.

Requirements

Associate degree or two-year degree in math, statistics, finance, accounting, or a related field is required.
1–3 years of job-related experience.
SQL experience is required.
Intermediate knowledge of Excel, Word, and PowerPoint.
Intermediate knowledge of email.
Ability to stay organized amid multiple interruptions.
High attention to detail.
Analytical skills to solve routine problems.
Excellent time-management skills.
Good oral communication skills.
Ability to work well with a variety of individuals.
Ability to work independently.

Nice To Haves

Familiarity with Power BI.
Bachelor’s degree in math, statistics, finance, accounting, or a related field.

Responsibilities

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