Decision Support Specialist 3 - UCI Health Plan Administration - FT Days

University of California, Irvine•Placentia, CA

55d•Onsite

About The Position

Provides senior level analyst support for medical economics analysis activities, including extracting, analyzing and synthesizing data from various sources to identify risks and opportunities, and improve financial performance system's operational, financial and strategic decision making. Includes the development of a case-based.

Requirements

Understanding of value-based risk arrangements.
Thorough understanding of decision support systems, with knowledge of business statistics, quantitative methods, relational databases, business development scorecards, data modeling, and performance and profitability analysis.
Thorough knowledge of issues in clinical finance, planning, financial data management, and business development.
Skills to effectively utilize the tools to produce meaningful findings and actionable intelligence.
Strong written and verbal communications skills, with the ability to interpret and convey complex technical and financial information in a clear, concise manner, and to make cogent presentations of analyses, reports, and investigation results.
Strong time-management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines.
Strong problem-solving skills and analytical ability, and strong knowledge of documentation and reporting, with the ability to run queries, complex studies, and forecasts.
Strong interpersonal skills, with the ability to collaborate effectively on complex projects in a team environment with interdepartmental personnel at a variety of professional and technical levels.
Strong critical-thinking and attention to detail.
Proven ability to work with senior staff and managers across departments, serving as a technical resource in decision support, and providing recommendations and advice on decision support processes, business and financial issues, and industry trends and advances.
Proficient in Microsoft Office suite products, key skills in Excel (VLOOKUPs and pivot tables)/applicable software program(s) proficiency.
Knowledge of health care operations (utilization management, disease management, HEDIS quality measures, claims processing, etc.).
Knowledge of health care financial terms (e.g., PMPM, revenue) and different standard code systems (ICD-10CM, CPT, HCPCS, NDC, etc.) utilized in medical coding/billing (UB04/1500 form).
Experience in quantifying, measuring, and analyzing financial, operational, and/or utilization metrics in health care.
Effective verbal and written communication skills.
Detail oriented, with strong ability to effectively manage time.
Skills to effectively address complex, urgent issues as they arise.
Demonstrated understanding of key managed care concepts and provider reimbursement principles such as risk adjustment, capitation, FFS (Fee-for-Service), Diagnosis Related Groups (DRG's), Ambulatory Patient Groups (APG's), Ambulatory Payment Classifications (APC's), and other payment mechanisms.
Demonstrated understanding of Medicaid and Medicare programs or other health care plans.
Demonstrated problem-solving skills.
Bachelor's degree in statistics, mathematics, finance, economics, computer science, health care management or related field.
At least 3 years of health care analytics and/or medical economics experience, or equivalent combination of relevant education and experience.
Analytical work experience within the health care industry (i.e., hospital, network, ancillary, medical facility, health care vendor, commercial health insurance, large physician practice, managed care organization, etc.).
Ability to mine and manage information from large data sources.
Must be able to provide proof of work authorization.

Responsibilities

Extracting, analyzing and synthesizing data from various sources to identify risks and opportunities.
Improving financial performance system's operational, financial and strategic decision making.
Developing a case-based analysis.