Healthcare Data Analyst

Univera Healthcare•Rochester, NY

4d•Hybrid

About The Position

This position has the responsibility to consult with the business/departmental leads and staff to gain an understanding of our business (i.e. lines of business leadership inclusive of Finance, Marketing and Sales, Health Care Network Management (HCNM), Operational Excellence (OpEx), Safety Net (SN) program owners-as applicable). This position extracts, analyzes, shapes and develops reports in ways that can be easily understood. The consultant monitors trends, brings forward opportunities and insights found in the data to the applicable audiences. This position partners with other analytics units (i.e. Analytics and Data) to collaboratively work on predictive modeling opportunities as well as utilize tools/data developed by other analytic units for deeper analysis of claims and other data. Essential Responsibilities/Accountabilities: Level I: Develops ongoing knowledge of Health Plans tools and data sources/structures (i.e. Enterprise Data Warehouse (EDW) and/or Medical/Pharmacy Management systems) to accurately pull data. Independently seeks to understand the business/programs and partners at the Health Plan to better understand the business requirements (the ‘why’) of the request and applies both knowledge of the business and analytic skills to proactively fulfill request. Prepares, develops, analyzes, shapes and delivers reports in an accurate and timely manner that ‘tell a story’ including but not limited to health plan cost and utilization trends, monitoring effectiveness of care management programs, clinical variation and data mining to find potential opportunities to better control costs and utilization, as needed. Compiles complex data sets and simplify/tailor according to audience delivering analyses to. Evaluates and processes raw data for user friendly and provides actionable insight (visual and otherwise) to end users. Collaborates with team members, leveraging skill sets across the team and aiding in growth and development as needed. Proactively problem solves, investigates and tactfully brings forward concerns to management and/or business partners with relation to data pulls and analyses, as appropriate. Uses Health Plan defined populations and appropriate analytic tools to pull data set to identify membership (at the highest level) for downstream data analysis of claims, care management programs, etc. Partners with other specialized analytic units (i.e. Business Intelligence) to develop automated production reports, dashboards and cubes for efficiency when appropriate. Builds collaborative relationship across functional teams and other analytic teams across the organization. Manages, organizes and prioritizes tasks for multiple projects with competing deadlines to successful completion. Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies’ mission and values, adhering to the Corporate Code of Conduct, and leading to the Lifetime Way values and beliefs. Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures. Regular and reliable attendance is expected and required. Performs other functions as assigned by management. Level II (in addition to Level I essential responsibilities/accountabilities): Utilizes SAS, Cognos, Microsoft and/or other tools (i.e. DataFlux, Winscp, AQT, etc.) to develop reports as appropriate and in-depth knowledge of either Health Plan EDW (or related claims data sets) or Medical/Pharmacy Management Systems while becoming familiar with the other data sets or systems. Assists in training and mentoring fellow analysts as directed by management. Participates and represents as a subject matter expert (SME) in cross-sectional team meetings or with business partner leads or other departments as needed. Participates on departmental and Health Plan project teams to recommends and/or develops comprehensive data strategies for optimal SAS/BI Tool utilization and connectivity with other BI tools. Devises strategy for producing deliverables, selecting and utilizing the most appropriate analytic tool, as well as, to begin to build process efficiencies. Level III (in addition to Level II essential responsibilities/accountabilities): Utilizes all relevant and available tools that optimize reporting efficiency for consumption by business partners and/or provides the business partners the user-friendly tools to run repetitive reports self-service. Uses knowledge of both the claims data sets/warehouses available and the Medical/Pharmacy Management systems to produce reports that tie the information (claims plus health plan or vendor partner management) that illustrates the effectiveness of health plan and provider partner programs as they relate to trend, program development opportunities, value of management programs to be used both internally and externally. Contributes, in partnership with Data Science to develop predictive cost savings models (or other types of models) and to quantify the value and impact of the department management programs (program specific) for business use to both external and internal partners, ultimately helping to sell programs to employer groups, as needed. Provides expertise in relational database concepts to analytics areas, as well as, customers. Seeks out opportunities to train and mentor fellow analysts within the framework of the department. Demonstrates keen judgment on involved and complex assignments; devises methods and procedures to meet unusual conditions and makes original contributions to the solution of very difficult problems. Level IV (in addition to Level III essential responsibilities/accountabilities): Recommends to leadership advanced analytic models and/or research that financially impact pricing, cost containment, quality, marketing and risk management functions. Develops large, complex advanced analytic models and performs data mining functions to identify trends in the data and/or opportunities for improved outcomes, as appropriate. Provides consultation, complex performance analysis, and coaching expertise to team member around methods of continuous quality improvement. Fosters a culture of continuous improvement that includes the use of performance data to understand health care cost and utilization trends, clinical and condition management analysis, health care cost containment, data quality measurement, and predictive modeling. Improves visual analytics throughout the organization. Interacts with Health Plan leadership to interpret model output and make business inferences that address strategic needs. Assesses need and opportunity for upgrades to existing or new analytic products (i.e. SAS or Cognos products). Prepares and submits studies for journal publication or presentation at national meetings, as needed.

Requirements

Bachelor’s degree in Mathematics, Statistics, Medical Informatics, Economics, or related field.
Minimum of 0 - 2 years’ experience in data or information analysis and reporting (for Level I).
Knowledge and applicable use of all tools available to develop analyses, extract information and using the most appropriate tool for the given report (i.e. SAS, Cognos, Excel, Access, SPSS, DataFlux, AQT, Winscp, puTTy etc.).
Ability to approach data analysis with different data mining techniques, statistical techniques (when applicable).
Proficient in using SAS and/or Cognos and Microsoft tools.
Working knowledge of Microsoft Office Suite.
Knowledge of basic statistical concepts.
Strong analytical and problem-solving skills with attention to detail.
Demonstrated ability to take complex data sets and simplify for all audiences to understand through both visual interpretation and highlighting data points of significant impact or potential areas for impactful program development.
Willingness to develop relationships with partners within the health plan to both understand data requests and help to shape the request for more influential impact.
Demonstrates intermediate understanding of healthcare products and operational business knowledge.
Demonstrated analytic abilities combined with capabilities for completing projects with minimum degree of supervision.
Excellent oral and written communication skills with aptitude for communicating to a variety of audiences.
High degree of initiative, proactive attitude and commitment to teamwork.
Demonstrated ability to effectively and tactfully relate to internal and external customers.
Possess the ability to work collaboratively with requestors and/or business partners.
Adaptable to constant industry change and rapidly changing priorities.
Minimum of three years’ analytic experience (for Level II).
Strong PC/programming skills including Microsoft Office Suite, VBA, SQL, Power Play and Impromptu and moderate proficiency in SAS required (for Level II).
Ability to quickly develop expertise in new application domains and analytic tools (for Level II).
Consistently demonstrated high quality and accuracy of work (for Level II).
Self-motivation, initiative, and an ability to perform under pressure with little supervision (for Level II).
A minimum of five years’ experience using statistical concepts and tools (for Level III).
Demonstrated expertise in relational database concepts (for Level III).
Demonstrates advanced statistical capabilities, data mining, forecasting and predictive modeling skills, and/or actuarial techniques (for Level III).
Demonstrated skills in quality principles especially root cause analysis and problem solving (for Level III).
Demonstrated business and technical problem-solving skills (for Level III).
Extensive experience in analytic tools required (i.e. SAS, Cognos, SPSS, or others) (for Level III).
A minimum of three years’ health care specific predictive modeling experience or seven years of experience in health informatics (for Level IV).
Ability to create, develop/validate models independently (for Level IV).
SAS Base Certification required (for Level IV).
Advanced analytic software programming proficiency required (i.e. experience with SAS EBI suite, Information Maps, Stored Processes, Web Report Studio, Information Delivery Portal) (for Level IV).

Nice To Haves

Knowledge of the health care system and experience working with physician or hospital claims/group data preferred.
In depth knowledge of product and member desirable.
Healthcare or Health Insurance industry experience preferred (for Level II).
Master’s degree preferred (for Level II).
Master’s Degree with at least two years of statistical analysis preferred (for Level III).
MS or MA in Statistics, Economics or related discipline preferred (for Level IV).
SAS Advanced Certification preferred or similar Analytic Software certification (for Level IV).
Project Management/Process Improvement knowledge preferred (for Level IV).
Project Management (PMP, Six Sigma) experience desired (for Level IV).

Responsibilities

Consult with business/departmental leads and staff to understand business needs.
Extract, analyze, shape, and develop reports that are easily understood.
Monitor trends and identify opportunities and insights from data.
Partner with other analytics units on predictive modeling and data analysis.
Develop ongoing knowledge of Health Plans tools and data sources/structures.
Understand business requirements and apply analytic skills to fulfill requests.
Prepare, develop, analyze, shape, and deliver reports on cost and utilization trends, program effectiveness, and cost control opportunities.
Compile and simplify complex data sets for different audiences.
Evaluate and process raw data to provide actionable insights.
Collaborate with team members and leverage skill sets.
Proactively problem-solve and address data-related concerns.
Use defined populations and analytic tools to identify membership for data analysis.
Partner with Business Intelligence to develop automated reports and dashboards.
Build collaborative relationships across functional and analytic teams.
Manage, organize, and prioritize multiple projects with competing deadlines.
Demonstrate high standards of integrity and adherence to company values.
Maintain member privacy in accordance with corporate policies.
Utilize SAS, Cognos, Microsoft, and other tools for report development.
Assist in training and mentoring fellow analysts.
Participate as a subject matter expert in meetings and project teams.
Recommend and develop comprehensive data strategies.
Devise strategies for producing deliverables and building process efficiencies.
Utilize tools to optimize reporting efficiency and enable self-service for business partners.
Produce reports that illustrate the effectiveness of health plan and provider partner programs.
Contribute to the development of predictive cost savings models.
Provide expertise in relational database concepts.
Demonstrate keen judgment on complex assignments and make original contributions.
Recommend advanced analytic models and research to leadership.
Develop large, complex advanced analytic models and perform data mining.
Provide consultation, performance analysis, and coaching on continuous quality improvement.
Foster a culture of continuous improvement using performance data.
Improve visual analytics throughout the organization.
Interpret model output and make business inferences to address strategic needs.
Assess the need for upgrades to analytic products.
Prepare and submit studies for journal publication or presentation.