About the Company:
A Fortune 500 company, is a diversified, multi-national healthcare enterprise that provides a portfolio of services to government sponsored healthcare programs, focusing on underinsured and uninsured individuals. Many receive benefits provided under Medicaid, including the State Children's Health Insurance Program (CHIP), as well as Aged, Blind or Disabled (ABD), Foster Care and Long Term Care (LTC), in addition to other state-sponsored/hybrid programs, and Medicare (Special Needs Plans).
The Company operates local health plans and offers a range of health insurance solutions. It also contracts with other healthcare and commercial organizations to provide specialty services including behavioral health management, care management software, correctional healthcare services, dental benefits management, in-home health services, life and health management, managed vision, pharmacy benefits management, specialty pharmacy and telehealth services.
Lead analytical data needs for all HP’s and business units.
Initiate and lead company wide data processes improvements
Lead cross functional activities related to large-scale analytic projects to deliver on schedule, within budget and with superior quality
Develop and lead activities to accomplish overall strategic department goals and lead the communication of these goals to stakeholders at all levels of the organization
Collaborate with health plan leadership to understand their data analysis needs, explain trends in data and actively drive further research and/or operational changes to assist in controlling medical costs and delivery of quality healthcare to members
Participate in cross health plan initiatives and capabilities, including data analysis support
Lead development efforts with technical team liaisons, including business requirements gathering and documentation, testing, delivery and user adoption, and effectively communicate deliverable expectations to the health plans and business units
Lead system/tool implementation and design as needed
Bachelor’s degree in data related field.
9+ years of data analysis experience, preferably in risk adjustment analytics with a healthcare payor or 7+ years of related IT experience, including data warehouse, coding or ETL experience. Advanced SQL and Microsoft Access skills, relational database knowledge, and various data reporting tool experience preferred.
Knowledge of statistics and application of high level mathematical models in medical and pharmacy claims data preferred.
Understanding of health insurance business, claims payment procedures, strategies and trends in health care government programs preferred.
Master’s degree and supervisory experience preferred.
Encounters experience preferred.
The company offers more than just medical insurance. They pay most of your benefits costs and in some cases – they pay 100 percent. Most of the benefits not covered by the company are paid with pre-tax payroll deductions.
Flexible spending accounts (includes health care, dependent care mass transit reimbursement)
Short- and long-term disability insurance
Basic Life insurance
Supplemental life insurance
401(k) retirement with company match
Employee stock purchase plan
Vacation, Personal and Sick time
Paid Company Holidays
Employee Assistance Program (EAP)
Training and Learning Opportunities
Tuition Reimbursement/Educational Assistance
On-site fitness center or discount at local fitness centers (most locations)
Discounts for select local and national products and services, including cell phones, computers and more
Other amenities may be available, but vary by location