Address
Form of work
SalarySummary:
- Work with other team leaders to improve operational efficiencies and resource allocations for improved performance of the EmblemHealth plans.
- Responsible for running queries and providing required analysis to understand related drivers (such as medical cost and utilization), and to provide insightful commentary and sensitivity modeling analysis.
- Develop data-driven analysis for decision making on how EmblemHealth purchases, manages, and influences the cost of care for current and prospective members.
- Extract, analyze, and interpret data for more complex insights related to cost drivers and to manage the escalation of issues that impact costs, and impact of health cost containment initiatives.
- Provide consultative subject matter expertise to aligned business areas to demonstrate analytics rooted in data.
Responsibilities:
- Ensure data integrity is maintained throughout the reporting lifecycle.
- Implement reporting and reconciliation workflows and document processes.
- Responsible for experience studies and medical trend studies.
- Perform research and collection of data, including data mining and reporting, which is provided to various customers inside and outside the department.
- Implement automation of manual reporting and analysis of business implications and trends.
- Lead efforts to continually improve data capabilities and quality of department analysis and reporting.
- Create, develop, and design analytics and reporting to measure or estimate financial impact of health plan business problems and potential or actual solutions, addressing escalated issues with subject matter expertise.
- Lead and manage several corporate and health cost containment initiatives, supporting staffing to deliver results across all functions within Medical Economics including.
- Develop research and analytic processes to review financial data to draw conclusions for senior leadership.
- Represent the department to internal and external partners with presentation of data and results for use in administering specific programs and processes related to medical expense and utilization.
- Present analytical findings to internal business partners, leading discussions and providing delivery of further analysis.
- Analyze business problems related to financial experience of the health plan, particularly related to how care is purchased, managed, or other factors influencing cost of care.
- Perform additional duties as assigned.
Requirements:
- BA/BS in Mathematics, Statistics, Economics, Healthcare or related discipline required; Master’s preferred.
- 4 – 6+ years of relevant, professional work experience required
- Experience querying, summarizing, and manipulating data using SQL or SAS required
- High level of proficiency with MS Office (Word, Excel, PowerPoint, Outlook, etc.), with an emphasis on Excel required
- Experience working in a healthcare setting (within a provider health system or health insurance company) preferred
- Experience working with healthcare data including but not limited to claims, testing results and pharmacy data required
- Strong communication skills (verbal, written, presentation, interpersonal) required
- Experience preparing/presenting dashboards and data using a data visualization tool such as Tableau preferred
Additional Information
- Job Type: Standard
- Schedule: Full-time
- Employee Status: Regular
- Requisition ID: 1000001655
- Hiring Range: $63,000-$110,000
