Benefit Management Analyst I

SKYGEN•Menomonee Falls, WI

15h•$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 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 team, clinical staff, provider relations, and developers. This is a permanently remote position with flexible daytime hours Monday through Friday and required core availability from 9:00 AM to 3:00 PM CST.

Requirements

Associate degree/two-year degree in mathematics, statistics, finance, accounting, or a related field is required.
One to three years of job-related experience.
SQL experience is required.
Intermediate knowledge of Excel, Word, and PowerPoint.
Intermediate knowledge of email.
Ability to stay organized while managing 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 mathematics, statistics, finance, accounting, or a related field.

Responsibilities

Maintain organized internal information and document and track departmental activity and results.
Analyze provider data to identify performance outliers and provide in-depth analysis of provider data and payments to identify potential outliers or trends.
Assist in identifying root causes and communicate findings to appropriate staff.
Ensure cases are properly 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 for taking 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 network performance in each market.
Coordinate random chart audits of targeted providers to ensure standards are met and appropriate peer committee reviews take place.
Use internal systems to generate information and analyze system reports.
Collaborate with the client experience team, clinical staff, provider relations, and developers.