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Healthcare experience, but not neccessary to have actuarial certification
This position is the primary analytic resource to support evolving risk and Pay for Performance financial and performance results, including support related to incentive payment programs and efficiency reporting. In order to complete analyses, the candidate must perform their own data extractions and manipulations. The candidate must have strong analytical skills in order to identify and communicate key observations and make recommendations to all levels of the organization.
Work with complex data, using SAS and MS Access, to develop and produce standard and ad hoc reporting and analysis to support Provider Reporting Unit.
Provide ad-hoc reporting to support provider contracts and support incentive program processes
Identify areas of opportunity and risk through the analysis of cost and utilization data including benchmarking, best practices, data trends, and practice pattern variation.
Act in a consultative role, both with internal and external customers, to provide potential solutions and options based on data results and findings.
Ability to document business requirements and high-level system requirements.
Take primary analyst ownership and act as Subject Matter Expert with second generation data warehouse databases, such as PIRS and QEDM, for use in Provider Financial Management, AQC and Risk Contract Performance, and other Performance and Settlement data and reporting needs.
3-5 years of related experience, preferably in healthcare insurance with knowledge of healthcare data.
Solid understanding and knowledge of healthcare data systems, including healthcare delivery, reporting and analytics. |
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