Healthcare Analyst II
About The Position
The Healthcare Analyst II is responsible for analyzing healthcare utilization to identify patterns, variation, and outliers as well as identify and quantify opportunities to reduce medical costs. This role involves evaluating the effectiveness of cost reduction initiatives, developing tools for market performance comparison, and providing analysis to inform network provider performance improvement. The analyst will also monitor clinical programs and support ad-hoc analytics requests across the organization. Additionally, the role requires identifying variables and methodologies for population segmentation and conducting root cause analyses of adverse population health outcomes.
Requirements
- Bachelor’s Degree or equivalent years of relevant work experience is required
- Minimum of two (2) years of experience in healthcare analytics is required
- Knowledge of healthcare data, including medical and pharmacy claims, EMR data, HIE data, UM data and demographic data
- Proficient in with Excel, Word and PowerPoint
- Proficient with Transact-SQL or SAS or Microsoft Power BI or Tableau
- Ability to organize data in a way that facilitates inferences, conclusions and decisions
- Demonstrated written and verbal communication skills
Nice To Haves
- Managed care experience is strongly preferred
- Knowledge of Medicaid, Medicare and other government sponsored healthcare programs is preferred
Responsibilities
- Analyze healthcare utilization to identify patterns, variation, and outliers
- Identify and quantify opportunities to reduce medical costs within the markets
- Evaluate the effectiveness of medical cost reduction initiatives
- Develop tools to efficiently compare market performance across and within products
- Provide analysis and recommendations to inform network provider performance improvement
- Monitor the efficiency and efficacy of clinical programs, interventions and processes
- Support the intake, prioritization and coordinated execution of ad-hoc analytics requests from departments across the organization
- Identify the variables and methodologies (e.g., qualitative, quantitative, spatial) that define population cohorts that can be positively impacted through targeted programs and interventions
- Segment population data to gain holistic intelligence via longitudinal trend analyses and advanced cluster analyses
- Conduct root cause analyses of adverse population health outcomes based on demographic, socioeconomic and clinical factors
- Perform any other job duties as requested
Benefits
- Bonus tied to company and individual performance
- Substantial and comprehensive total rewards package
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
