Healthcare Analyst II

CareSource • Dayton, OH

7d

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. The CareSource mission is known as our heartbeat. Just as we support our members to be the best version of themselves, our employees are driven by our mission to create a better world for members, stakeholders and providers. We are difference-makers who combine compassionate hearts with our unique business expertise to make every opportunity count. Each claim, each phone call, each consumer-centric decision is a chance to change the world for one member, and our employees look for ways to do that every day. The challenge is, there is no one right way to be the difference and we’re looking for people like you that will rewrite that definition every day. We do what it takes to form creative solutions that make our community and the world just a little better. Discover what it means to be #UniquelyCareSource.

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

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 1,001-5,000 employees