Job Summary:
The Healthcare Analyst II VBR is responsible for analyzing healthcare utilization to identify patterns, variation, and outliers as well as identify and quantify opportunities to reduce medical costs.
Essential Functions:
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Analyze healthcare utilization to identify patterns, variation, and outliers
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Identify and quantify opportunities to reduce medical costs within the markets
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Evaluate the effectiveness of medical cost reduction initiatives
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Develop tools to efficiently compare market performance across and within products
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Provide analysis and recommendations to inform network provider performance improvement
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Monitor the efficiency and efficacy of clinical programs, interventions and processes
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Support the intake, prioritization and coordinated execution of ad-hoc analytics requests from departments across the organization
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Identify the variables and methodologies (e.g., qualitative, quantitative, spatial) that define population cohorts that can be positively impacted through targeted programs and interventions
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Segment population data to gain holistic intelligence via longitudinal trend analyses and advanced cluster analyses
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Conduct root cause analyses of adverse population health outcomes based on demographic, socioeconomic and clinical factors
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Perform any other job duties as requested
Education and Experience:
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Bachelor’s Degree or equivalent years of relevant work experience is required
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Minimum of two (2) years of experience in healthcare analytics is required
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Managed care experience is strongly preferred
Competencies, Knowledge and Skills:
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Knowledge of healthcare data, including medical and pharmacy claims, EMR data, HIE data, UM data and demographic data
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Knowledge of Medicaid, Medicare and other government sponsored healthcare programs is preferred
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Proficient in with Excel, Word and PowerPoint
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Proficient with Transact-SQL or SAS or Microsoft Power BI or Tableau
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Ability to organize data in a way that facilitates inferences, conclusions and decisions
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Demonstrated written and verbal communication skills
Working Conditions:
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General office environment; may be required to sit or stand for extended periods of time
Compensation Range:
$72,200.00 - $115,500.00
CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.
Compensation Type (hourly/salary):
Salary
Organization Level Competencies
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