Job Location

Salary Range

Duty areas fulfilled by candidate:

• Using intermediate statistical knowledge and while working with imperfect or dirty data, create internal and external facing clinical activity or utilization reports or analytics deliverables used to fulfill population health analysis requirements for our clinical and social health businesses
• Understand complex business rules dictated by health plan contracts on enrollment, eligibility, clinical and social care, SLA fulfillment
• Understand data discrepancies that can distort accurate data deliverables
• Understand how to model and forecast unit costs to explore what-ifs and validate operational hypotheses
• Understands the medical coding for patient encounters, diagnostic and procedural information
• Understands how medical reimbursement is dependent on correct medical coding
• Analyze and improve supply/demand resource capacity models
• Understand the impact of change management on rules and functions and how to design changes that lead to economic efficiencies
• Able to lead the communication around productive BPM reengineering at the detailed level, including defining statuses, metrics, dashboards, objectives, conflicting priorities, and incentives
• Nice to have: understanding of how to model business revenue cycle management processes, across diverse roles, geographies, areas of focus, and internal product types, particularly in the pursuit of risk sharing with large health plans

Qualifications

• Strong analytical skills to work with claims and admissions data, work around data quality issues and produce analytical deliverables such as utilization improvements or contributing patterns in clinical coding
• Bachelor's or masters degree in Biostatistics, Computer Science, MIS, math, statistics, MPH, accounting, or a related analytical or technical field
• Usable intermediate or advanced statistical knowledge applicable to working with clinical operations data
• Python 3.0 (or similar scripting language) Proficiency to manipulate billing or claims data
• Plus: Salesforce Report creation and Maintenance (e.g. Sales cloud)
• Nice to have: 4+ years of recent experience working with claims in population health environments
• Advanced Working proficiency of Excel,
• Basic proficiency of SQL, Word, PowerPoint, relational database design

Traits:

• Interested to tackle healthcare domain challenges that when solved can improve the lives of others
• Possesses analytical confidence to dig in and figure things out
• Excels at collecting, researching, presenting, operational information and receiving feedback
• Pragmatism to deliver data deliverables on time and on budget
• Excellent analytical skills and self-organization
• Enjoys small-company culture and working in cross-functional distributed teams without siloed job roles