Job: Managed Care Analyst

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Posted: 06/06/2017

Job Status: Full Time

Job Reference #: 52

Job Description

Managed Care Analyst FEATURED

Business Office ยท Business Analytics
Plantation, FL
Health Care
Full Time (30 - 40 hours), Days, Monday - Friday 8-5pm
Bilingual: None
Bilingual Type: Other Language
Posted 06/05/2017
Req # 53
  • PRIMARY FUNCTION
    • Managed Care Analyst will be responsible for the design and development of analyses and reporting of claims, member and clinical data from Insurance plans using business intelligence tools, statistical, and analytical techniques.  The analyst will have an active role supporting global risk contracts.
  • ESSENTIAL FUNCTIONS OF THE JOB
    • This list may not include all of the duties that may be assigned.

    • Conduct contract valuation analysis by creating financial models (Fee for service, capitation, gainshare, etc.)
    • Develop insight into member and provider performance and the variables affecting performance
    • Provides technical and analytical expertise for the evaluation, interpretation and analysis of managed care data
    • Analysis of plan claims data to assess trend performance, analyze company performance vs. contract parameters, as well as investigate potential operational and clinical opportunities.
    • Implementation of special initiatives to support the analytical/reporting needs of the company
    • Compile key managed care statistics.
    • Research managed care capitation issues related to eligibility and coordinate resolution.
    • Enhance, maintain, and analyze variance reporting by payer and type of issue.
    • Develop standard report templates for consistency in data analysis.
    • Provide user specific ad hoc reporting as requested.
    • Experience in data analysis/data mining is a must.
  • PERFORMANCE REQUIREMENTS
    • Education:
      • Associate’s degree or higher

    • Licensure:
      • None Listed

    • Knowledge, Skills & Abilities:
      • Proficient in writing queries in SQL.
      • Proficient with Microsoft Excel
      • Performs other duties as assigned
      • Ability to work independently and in a strong team environment
      • Ability to project a positive attitude and high degree of self-confidence
      • Ability to effectively manage time
      • Strong analytical, research, and problem solving skills
      • Strong verbal and written communication skills

    • Experience:
      • 3years’ experience in a healthcare financial setting (provider or health plan based) with at least 2 of the total years experience in contract analysis/modeling or financial reporting
Additional Info

EDUCATION: Analytics, Finance, and/or Mathematics Associate's degree or higher

Healthcare Industry Knowledge preferred.

EXPERIENCE: 3 years’ experience in a healthcare financial setting (provider or health plan based) with at least 2 of the total years’ experience in contract analysis/modeling or financial reporting, In addition, recent graduates welcomed.

PERFORMANCE REQUIREMENTS:

  • Proficient in writing queries in SQL.
  • Proficient with Microsoft Excel
  • Performs other duties as assigned
  • Ability to work independently and in a strong team environment
  • Ability to project a positive attitude and high degree of self-confidence
  • Ability to effectively manage time
  • Strong analytical, research, and problem solving skills
  • Strong verbal and written communication skills

Application Instructions

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