Healthcare Analyst II – Vendor Management
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Job Description
Healthcare Analyst II analyzing healthcare utilization to identify opportunities to reduce costs. Collaborating to improve provider performance and clinical program efficiency in a remote role.
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
Requirements:
- Bachelor’s Degree or equivalent years of relevant work experience
- Minimum of two (2) years of experience in healthcare analytics
- Managed care experience is strongly preferred
- Knowledge of healthcare data, including medical and pharmacy claims, EMR data, HIE data, UM data and demographic data
- Knowledge of Medicaid, Medicare and other government sponsored healthcare programs is preferred
- 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
Benefits:
- substantial and comprehensive total rewards package
- bonus tied to company and individual performance
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