Analyst

Primary Responsibilities and Job Duties:

• Perform statistical population health utilization, cost and quality analytics to develop cost of care targets for at-risk populations
• Conduct margin analysis on infusion drugs and oral drugs, identify margin drivers, run deep dive analysis to explain trends and assess opportunities
• Perform profitability analysis on capitation as well as FFS contracts
• Working with our RCM team, conduct in-depth reviews of claims AR and payments to assess collection results and trends, reporting findings to various internal teams and senior leadership
• Working with business partners in Business Development, UM, Clinical/Ops, prepare financial models to assess ROI around operational expansion initiatives
• Support and inform clinical, network and efficiency improvement initiatives through complex analytics and financial modeling using SQL language
• Provide analytical research and due diligence for investment activities and accounting audits
• Responsible for source system data analyses, identification of business rules and data elements for data transformation/migration into the data warehouse. Assists with data sharing and reconciliation among the various data systems as well as developing methods for standardizing data collection, database design, validation reports and analysis
• Utilize tools for monitoring quality of data and assists in development of corrective action plans when issues are discovered

Required Qualifications:

Experience:

• Requires two (2) plus years’ work experience in a financial/medical economics analysis role.
• Experience working with and extracting insights from various healthcare related data files, such as claims (CPT, ICD), eligibility, capitation, oral drugs, and others
• Understanding of accounting, investment concepts and ability to bridge between operational data and reported financial results
• Experience in creating analytics package and presenting findings to senior leadership

Computer Skills:

• Advanced proficiency in Microsoft Excel including PivotTables, Power Query, and advanced formulas.
• Advanced proficiency in SQL (SSMS). Ability to manage relational databases, create and update tables, stored procedures,
• Proficient in Power Bi including report development and dashboard design.
• Proficient in Microsoft Word, Access and PowerPoint. Ability to create analytics package and present findings to senior leadership

Posted On: Sunday, January 12, 2025
Compensation: $120,000.00