Supports the medical cost position of assigned markets through analysis of healthcare provider contracts
Analysis of high performing network solutions
Analysis of medical expense reports
Data drill downs of trend drivers
Execution of key initiatives designed to address medical expense and product pricing trends
Partners with network management and pricing units to deliver medical expense results in line with trend/cost expectations

Requirements

5+ years' experience with health care data analysis required
Technical sophistication with various data mining and business intelligence tools such as SAS, SQL and advanced Microsoft Excel skills
Knowledge of standard medical coding including CPT-IV, ICD-10, DRG, revenue codes, and HCPCS
Understanding of managed care business processes, data, systems, and applications for claims payment, enrollment, benefit design, and utilization management
Experience with medical cost trend analysis and health care provider contract analysis preferred
Strong analytical and problem-solving skills with a proven track record of success
Ability to independently perform data analysis while managing multiple projects and meeting strict deadlines
Strong ability to validate and interpret results
Ability to influence and drive strategic planning and execution through engagement of business partners, education on key drivers and actionable levers, and thorough understanding of market-level dynamics
Strong communication skills to include written, oral, and group presentation.

Benefits

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Applicant Tracking System Keywords

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Hard Skills & Tools

health care data analysisdata miningbusiness intelligenceSASSQLMicrosoft Excelmedical codingCPT-IVICD-10DRG

Soft Skills

analytical skillsproblem-solving skillsproject managementcommunication skillsinfluencing skillsstrategic planningengagementeducationinterpretation skillstime management