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
Analyze healthcare utilization to identify patterns, variation, and outliers
Identify and quantify opportunities to reduce medical costs within the markets
Evaluate the effectiveness of medical cost reduction initiatives
Develop tools to efficiently compare market performance across and within products
Provide analysis and recommendations to inform network provider performance improvement
Monitor the efficiency and efficacy of clinical programs, interventions and processes
Support the intake, prioritization and coordinated execution of ad-hoc analytics requests from departments across the organization
Identify the variables and methodologies (e.g., qualitative, quantitative, spatial) that define population cohorts that can be positively impacted through targeted programs and interventions
Segment population data to gain holistic intelligence via longitudinal trend analyses and advanced cluster analyses
Conduct root cause analyses of adverse population health outcomes based on demographic, socioeconomic and clinical factors
Perform any other job duties as requested
Education And Experience
Bachelor’s Degree or equivalent years of relevant work experience is required
Minimum of two (2) years of experience in healthcare analytics is required
Managed care experience is strongly preferred
Competencies, Knowledge And Skills
Knowledge of healthcare data, including medical and pharmacy claims, EMR data, HIE data, UM data and demographic data
Knowledge of Medicaid, Medicare and other government sponsored healthcare programs is preferred
Proficient in with Excel, Word and PowerPoint
Proficient with Transact-SQL or SAS or Microsoft Power BI or Tableau
Ability to organize data in a way that facilitates inferences, conclusions and decisions
Demonstrated written and verbal communication skills
Working Conditions
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
Salary
Competencies
Fostering a Collaborative Workplace Culture - Cultivate Partnerships - Develop Self and Others - Drive Execution - Influence Others - Pursue Personal Excellence - Understand the Business
This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.