Health Alliance Plan · 10 hours ago

Healthcare Analytics Analyst II - Client Reporting (Remote) - Health Alliance Plan

Troy, MI

Full-time

Remote

Mid Level

3+ years exp

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Responsibilities

Conducts analysis associated with medical cost saving initiatives, leading indicators, rate model and pricing related data, contract efficiency with providers, and adherence to quality standards. Participates and/or leads cross-functional corporate business teams and meetings in the development of medical economics programs, targets, and results as they relate to specific corporate strategies and programs.

Develops best in class and forward-thinking methods/criteria for measuring and summarizing healthcare performance data. Integrates information from multiple sources, discerns implications for future analysis and identifies opportunities for enhancing integrity of medical data.

Prepares historical analyses (e.g., PMPM, Utilization per one thousand, and Price per resource) for targeted medical cost categories, geographies, and segments. Conducts analysis of membership mix and its resulting impact on utilization models. Validates findings against Milliman benchmarks. Utilizes baseline metrics and trends to establish medical cost savings forecast models.

Supports the development and implementation of strategic medical management and/or network management initiatives, product offerings or other strategic business programs through extraction, analysis and summarization of appropriate data sets and benchmarks.

Partners with IT, Data & Analytic Strategy, Finance, Actuarial, Sales, Product Management, Market Intelligence, Claim Services, Pharmacy Services, Provider Network Management, Utilization Management, and Population Health to champion, develop, and monitor sound cost valuation methodologies for medical and/or network management programs and initiatives.

Communicates and describes the findings to business questions and objectives pertaining to medical costs, contracting performance, and/or clinical/network performance to key leadership and/or stakeholders.

Prepares and delivers well-organized and compelling presentations to reflect key findings, analytic methods to determine such findings, future analysis, and implications; and the identifications of opportunities to drive business improvements.

Prepares reports and presentation for running the business meetings quarterly.

Performs other related duties as assigned.

Qualification

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SQLExcelData interpretationProject managementMicrosoft PowerBIAzureMedInsightRisk modelingForecastingHealthcare analyticsMedical claims dataManaged care dataBusiness intelligenceAdvanced Microsoft skillsProcess improvement

Required

Bachelor’s degree in Health Policy, Health Care Economics, Biostatistics, Epidemiology, Finance, Analytics, or other closely related field required.

Minimum of three (3) years of progressive analytical experience in a healthcare or managed care/insurance related setting.

Skills required: SQL, Excel.

Demonstrated experience with data interpretation, analysis, and reporting; clinical and financial data; risk modeling and forecasting; key performance indicators as it relates to medical cost data.

Demonstrated project management experience in running corporate wide projects.

The nature of the work requires progressive interpersonal communication, decision-making, financial and technical skills.

Must exhibit the ability to function in an autonomous manner in a rapidly changing environment.

High energy: strong leadership, analytical, project planning and coordination skills to enable efficient, timely task completion of deliverables that meet or exceed customer expectations.

Demonstrated ability to function in a creative, 'out-of-the-box' way of thinking to develop original solutions to overcome roadblocks and meet or exceed customer requirements and expectations.

Knowledge of medical claims data and managed care membership data.

Knowledge of business intelligence applications, data, and tools.

Advanced Microsoft analytic skills (e.g., Access, Excel, and PowerBI).