Health Care Analyst III

SCAN Health Insurance

31d

About The Position

SCAN Group is a not-for-profit organization dedicated to tackling the most pressing issues facing older adults in the United States. SCAN Group is the sole corporate member of SCAN Health Plan, one of the nation’s leading not-for-profit Medicare Advantage plans, serving more than 277,000 members in California, Arizona, Nevada, Texas and New Mexico. SCAN has been a mission-driven organization dedicated to keeping seniors healthy and independent for more than 45 years and is known throughout the healthcare industry and nationally as a leading expert in senior healthcare. SCAN employees are a group of talented, passionate professionals who are committed to supporting older adults on their aging journey, while also innovating healthcare for seniors everywhere. Employees are provided in-depth training and access to state-of-the-art tools necessary to do their jobs, as well as development and growth opportunities. SCAN takes great pride in recognizing our team members as experts in their fields and rewarding them for their efforts. If you are interested in becoming part of an organization that is innovating senior healthcare visit www.thescangroup.org, www.scanhealthplan.com, or follow us on LinkedIn, Facebook, and Twitter. Job Description: The Job Develops, documents, and programs in support of 5-Star projects and in-house initiatives. In pursuit of high 5-Star ratings, conducts in-depth data analysis and interpretation, HEDIS reporting, and other related tasks.

Requirements

Bachelor’s or above degree in Math, Statistics, Biostatistics, Computer Science, or other quantitative disciplines required.
5+ years of analytical experience, or 4+ years of analytical experience in a Healthcare/Managed Care environment required.
MS Office required
Proficiency with MS SQL (queries) required.
Excellent technical, interpersonal written and oral communication skills required.

Nice To Haves

Experience with HEDIS is preferred.
Experience with medical claims / encounters data is preferred.
SQL Server Reporting Services and SQL Server Integration Services experience preferred.
SAS (Statistical Analysis System) experience preferred.
Power BI tool experience preferred.

Responsibilities

Responsible for research and moderate analysis of Medicare Advantage and healthcare data specific to membership, provider, claims, authorizations, pharmacy, and financial information.
Designs and produces timely and meaningful analysis and data interpretation regarding large health care related datasets, related to 5-Star ratings, HEDIS, state specific programs (such as QIP/PIP), programs issued by state agencies (such as DHCS or HSAG) and other associated company initiatives.
Leads in development, implementation, and document quality assurance (QA) processes to ensure that reported data is accurate and reliable.
Conducts data management, quality improvement studies, statistical analysis, and report generation.
Presents findings to higher level Analysts as well as HCI mid and senior management.
Performs moderate to complex analysis and interprets organizational data, including but not limited to data mining, data verification, mapping, scrubbing, and scrapping.
Develops and deliver actionable and supportable findings within tight deadlines and changing requirements.
Conducts investigative research to uncover root causes, interpret results, identify trends, and make recommendations for action.
Works directly with internal and external stakeholders to troubleshoot and correct data anomalies.
Manages multiple moderate to complex projects concurrently.
Completes them accurately within a specified timeline by effectively prioritizing work and communicating workload issues to management.
Leads in training, providing guidance, and supporting lower level Analysts.
Serve as a point of contact for internal and external customers and resolves both routine and more complex questions and problems.
Escalates only the most complex issues to higher levels as needed.
Ensures understanding of business needs by proactively monitoring and clarifying the technical responses to business requirements on all Medicare related projects.
Actively support the achievement of SCAN’s Vision and Goals.
Other duties as assigned.

Benefits

Base Pay Range: $92,400 to $133,671 annually
An annual employee bonus program
Robust Wellness Program
Generous paid-time-off (PTO)
11 paid holidays per year, 1 floating holiday, birthday off, and 2 volunteer days
Excellent 401(k) Retirement Saving Plan with employer match
Robust employee recognition program
Tuition reimbursement
An opportunity to become part of a team that makes a difference to our members and our community every day!
A competitive compensation and benefits program;
An annual employee bonus program;
Generous paid-time-off (PTO);
Eleven paid holidays per year;
Excellent Retirement Savings program;
A work-life balance;
An opportunity to become part of a team that makes a difference to our members and our community every day!