Our client has developed a new model and market as a risk-bearing, value-based home-based services provider and post-acute care management company.
They are disrupting the industry by providing all the services and technology required to enable patients to remain in their home through a fully-integrated model across three core lines of service – homecare, home medical equipment (“DME/HME”) and home infusion / pharmacy – while also matching patients to the right site of care.
We are seeking an experienced healthcare analyst, to support all analytics needs with respect to a growing portfolio of health plan customers and physician MSO partners. The analyst will lead complex analyses that is critical to business decisions at the onset of a new client relationship, as well as address ongoing medical management operational needs.
Research, analyze, present results, and recommend intelligent solutions to solve problems and address business challenges by applying a knowledge of medical claims analysis, critical-thinking skills, and healthcare experience/expertise. This may range from developing proposals for new and existing clients, to clinical quality and utilization management projects, to new initiatives that you may come up with yourself.
Structure analytical results in an organized, visual manner to tell a meaningful, actionable story.
Write SQL queries, create end-user reports, and apply varying analytical techniques to solve specific business problems.
Determining credibility and usability of claims data prior to delivery of analytic results.
Interpret contractual language and have a clear understanding of business rules and reporting requirements
Establish trusting professional relationships with internal senior business customers.
Maintain alignment of expectations and priorities in autonomous fashion.
Undergraduate degree is required, master’s preferred in math, statistics, computer science, or other related quantitative field
2-4 years of experience or proven ability working as an analyst in the health care industry with medical claims, membership and provider data.
Proven experience working with some combination of Medicare, Medicaid, and Commercial paid claims data sets. Other applicable data sets include Census and Member Eligibility data sets.
Reasonable experience with Structured Query Language (SQL) required.
Advanced analytic skills with the ability to build statistical and predictive models to help support business decisions
Ability to analyze and interpret medical claims data through complex analysis that leads to strategic business decisions
Experience in data mining, statistical analysis, and data transformation/manipulation.
Experience working with large data repositories and/or relational databases.
Expertise in MS Excel, with proficiency using formulas, PivotTables, linked worksheets, graphing and other reporting and presentation features.
Ability to tell a succinct, meaningful, and actionable story with data using visualization and other techniques.
Ability to work on multiple projects simultaneously with minimal supervision.
Ability to quickly adapt to changes in both technology and business environments.
Highly self-motivated and directed with keen attention to detail.