Senior Financial Health Care Data Analyst III

HMSA•Honolulu, HI

1d•Hybrid

About The Position

This role is responsible for facilitating complex projects, developing and analyzing reimbursement and provider strategies, and ensuring compliance with workflows. The analyst will also mentor team members and serve as a role model within the organization, demonstrating courtesy, care, helpfulness, and respect in all interactions.

Requirements

Bachelor's degree and five years of related work experience; or equivalent combination of education and experience.
Proficiency in Data reporting and analysis
Demonstrated working knowledge of managed care/health care business processes, systems and application for claims payment, network, and provider contract administration.
Proficiency in project management skills
Intermediate working knowledge of Microsoft Office applications, including, but not limited to Word, PowerPoint, and Outlook.
Advanced working knowledge of Microsoft Excel.
Advanced working knowledge of MicroStrategy, SQL, SAS, or other query language.

Responsibilities

Facilitate complex projects and functions of high importance as an independent project lead.
Plan and manage the project development process and oversee implementation.
Analyze intricate project objectives, data sources, methodology, data summaries and findings, and prepare and edit draft, revised and final reports for dissemination to key project sponsors to meet information request specifications.
Coordinate and prioritize activities with internal and external staff for implementation and monitor work for accuracy. Ensure that outcomes meet HMSA's corporate goals.
Develop, analyze, recommend, and monitor reimbursement and provider strategies; prepare reports that measure the effectiveness of reimbursement and contracting terms and the influence they may have on overall program/plan cost and utilization.
Analyze data and identify trends, patterns, or other notable issues with an eye for cost reduction opportunities.
Monitor market trends to identify emerging opportunities or risks in business environments.
Monitor various websites for reimbursement and policy changes, focusing on Government entities; make recommendations for implementation of changes.
Communicate with various stakeholders, including physicians, hospital admin staff, other healthcare insurers, auditors, and other departments within the company.
Annual review of compliance workflows, such as, SSAE, MAR.
Independently participate in current audits; be able to respond comprehensively to auditor inquiries.
Review provider contracts and ensure that claims system set ups accurately reflect fully executed, signed agreements.
Mentor team members; provide feedback and direction on staff's work.
Serve as a team player and role model for other employees in the organization by always exhibiting traits of courtesy, caring, helpfulness, and respect; conduct oneself in a service-oriented manner that is attentive, pleasant, cooperative, sensitive, respectful, and kind when dealing with members, visitors, the public, and all employees.