Summary of Position
Extract, analyze and interpret data to produce both care management and utilization trend reporting and ad hoc analysis requests.Support all functions within Medical Management, including monitoring of specific corporate and health cost containment initiatives.

Principal Accountabilities

• Support research and analysis of clinical data; draw conclusions and provide consultation to internal and external partners for use in administering specific programs and processes related to medical expense and utilization.
• Perform detailed analyses, including accumulation of data, modeling, and reporting of outcomes of various clinical programs.
• Assist the business units to identify trend outliers, analyze the trend drivers and perform the work necessary to facilitate the discussion on possible solutions.
• May provide observations and recommendations based on analysis of patterns and data to enhance effectiveness, reduce costs, and improve processes.
• Responsible for clinical compliance reporting as well as identify process improvement opportunities.
• Conduct ongoing monitoring of medical cost savings and clinical initiatives.
• Develop ad hoc views of data that illustrates underlying trend issues for both cost and utilization.
• Perform additional duties as assigned.

Education, Training, Licenses, Certifications

• BA/BS Required in Mathematics, Economics, Healthcare or other quantitative discipline.

Relevant Work Experience, Knowledge, Skills, and Abilities

• 3 – 5 years of relevant, professional work experience. (R)
• Experience working in a healthcare setting (within a provider health system or health insurance company). (R)
• Experience with healthcare data including utilization management and production data, production metrics, claims and

testing results. (R)

• Proficiency with MS Office (Word, Excel, Powerpoint, Outlook, Teams, etc.), with an emphasis on Excel. (R)
• Strong communication skills (verbal, written, presentation, interpersonal). (R)
• Experience preparing/presenting dashboards and data using a data visualization tool such as Microsoft Power BI, Tableau. (R)
• Strong data querying skills using tools such as SQL or SAS Enterprise Guide. (P)

Additional Information

• Job Type: Standard
• Schedule: Full-time
• Employee Status: Regular
• Requisition ID: 1000000705
• Hiring Range: $75,000-$95,000

Job Type: Full-time

Pay: $75,000.00 - $95,000.00 per year

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Disability insurance
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Tuition reimbursement
• Vision insurance

Schedule:

• Monday to Friday

Work Location: Remote

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