Drive new offerings with an exciting organization in Genetic Testing and Musculoskeletal Care solutions.
Our client a leader in specialty benefit management is an innovator, leader and partner to payers and other risk bearing organizations that manage health outcomes and costs. They provide value through clinical appropriateness review, provider collaboration and member engagement. They design and administer solutions on behalf of 50 health plans, which support a diverse client base and over 42 million members, and engage with more than 330,000 providers throughout the US to help improve the quality of care and reduce costs.
Prospective clinical review of outpatient advanced imaging procedures
Clinical review for cardiology and specialty pharmacology products and services.
Oncology Management programs leveraging proven specialty benefit platform to drive consistent and effective cancer care through services review
Specialty Drugs programs to provide review for over 142 specialty drugs offering providers an automated drug review process through our provider friendly web portal.
Sleep Management, designed to align the diagnosis and treatment of sleep apnea against clinical guidelines, enhance member access to high value providers and ensure treatment compliance for the dispensing of supplies.
The programs combine clinical excellence, its innovative technology and a commitment to customer service, ensuring the company's on-going leadership in the rapidly evolving healthcare environment.
We are seeking several Health Information Consultants to partner with Solutions Managers to monitor performance and support strategic business cases with opportunity analyses.
Primary duties is focused on complex and varied metrics, making recommendations and providing program value guidance to solution managers. Responsible for analyzing, reporting and developing recommendations on data related to complex and varied business metrics. Creates and maintains data models to track solution value performance.
Analyzes data and summarizes performance and develops and analyzes solution performance reports (e.g. for claims data, operational data and provider pre-authorization data, utilization data). Partners with solution managers and takes business issue and devises best way to develop appropriate diagnostic and/or tracking data that will translate business requirements into usable decision support tools and analysis metrics
Provides business analysis in support of solution enhancements and new solution offerings.
Ideal candidate will have
BS/BA degree in related field, Master's degree preferred. Health care experience desired, Consulting experience desired. Must have 3-5 years data analysis; or any combination of education and experience, which would provide an equivalent background.
Experience with relational database, strong knowledge of SQL and Excel is required Experience with data mining and data analysis tools is preferred. Business Objects knowledge is preferred
Ability to manipulate large sets of data and strong analytical, organizational and problem solving skills. Ability to translate data in actionable information and recommendations through executive summaries and PowerPoint presentation.
Max Populi, LLC
4628 Bayard Street, #207
Pittsburgh, PA 15213-2750
Tel: (412) 567-5279
Fax: (412) 567-5198