ESSENTIAL JOB DUTIES/RESPONSIBILITIES:
Serve as a subject matter expert and consultant for health plan data, medical trends, cost drivers and cost saving opportunities; Analyze and research medical costs drivers; Support the development of scoreable action items by identifying outlier cost issues; Consult with Clinical, Network, Finance and Operations management on opportunities to improve outcomes and costs; Develops critical and complex information in support of strategic business plans; Present highly complex information in a way that multiple levels within an organization can understand and utilize to make appropriate decisions to meet business objectives; Work collaboratively across ChenMed to strengthen functioning of the enterprise and deepen knowledge, processes and expertise on Medical Economics; Collaborate with IT on improvement of integrated data warehouse strategy and business needs to help establish reporting consistency and alignment with data governance.
Applicants must have relevant analytical financial experience. An understanding of the healthcare industry is preferred. Familiarity with key managed care functions including provider contracting, benefit design, medical management as well as knowledge of business functions and impact on financials is also strongly preferred. Minimum of 1-2 years’ experience in the managed care industry with knowledge of Medicare Advantage, health insurance data, provider contracting and reimbursement, product and benefits design. Advanced skills in SQL, Python, PowerBI, QlikView, Excel, and data warehouse management preferred. Ability to learn new technologies. Strong analytical ability and familiarity with advanced financial and healthcare concepts. Demonstrates critical thinking and expresses ideas clearly, concisely and logically from a cross functional perspective. Ability to manage conflicting priorities and multiple projects concurrently. Demonstrates initiative, innovation and leadership in achieving results.
Other duties as assigned and modified at supervisor’s discretion.
KNOWLEDGE, SKILLS AND ABILITIES:
High business acumen and acuity
Strong analytical and quantitative skills
Excellent problem-solving skills with the ability to pay close attention to details
Proven ability to create and deliver communications (written and verbal) and presentations to audiences at all levels in the organization
Skilled at developing Business Intelligence and Analytics solutions
Proven ability to develop predictive data models using statistical and mathematical methods
Strong interpersonal skills with a demonstrated ability to partner, influence, consult and collaborate with all levels in the organization
Proven ability to meet deadlines and work in a fast-paced environment with changing priorities
Advanced in Microsoft Office Suite products including Word, Excel, PowerPoint and Outlook, plus a variety of other word-processing, spreadsheet, database, e-mail and presentation software
Good project management skills
Spoken and written fluency in English
This job requires use and exercise of independent judgment
Enthusiastic and positive attitude.
EDUCATION AND EXPERIENCE CRITERIA:
Bachelor’s degree in Business Administration, Engineering, Economics, Finance, Mathematics, Statistics, etc. Master’s level-education with a combination of technical and business background a plus.
Two or more years’ progressive experience in finance or analytics in the health care provider or health care insurance sectors with a focus on medical economics preferred. Experience in Medicare Advantage data analytics and strategy planning, preferred.
Mastery of Microsoft office products (Excel, PowerPoint, etc.) and is efficient in the production of content.
Experience in database programming, stored procedures, and automation.
Some Experience programming with a high-level scripting language (Perl, Python, C#, etc.).
Experience with advanced analytical and reporting software (e.g., QlikView, Tableau) a plus.
Exposure to or experience with ETL processes. SSIS experience a plus.