Job: Managed Care Analyst

This posting has expired and is no longer available.

Job Description

Managed Care Analyst FEATURED

Business Office ยท Business Analytics
Plantation, FL
Health Care
Full Time, 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
COMPANY OVERVIEW: Founded in 1955, Pediatric Associates is one of the oldest and most respected pediatric practices in the United States. Pediatric Associates opened its first office in Hollywood, Florida. The Company was one of the first medical groups to introduce satellite office locations in consumer retail locations. They were also one of the first pediatric groups to embrace managed care in the 1970s, collaborating with insurance plans as healthcare partners with the common interest of providing South Florida's children with the best healthcare available. Today, Pediatric Associates is a national leader in pediatric population health management with over 200,000 patients under global risk. Keeping abreast of medical advances and changing lifestyles, Pediatric Associate’s modern facilities offer comprehensive services, including X-ray and state certified laboratories. The Company currently has 33 neighborhood locations, which are staffed by more than 200 employed providers who proudly serve families throughout Miami-Dade, Broward, Palm Beach, St. Lucie, counties, including Tampa and Jacksonville. Pediatric Associates will continue to bring the best possible healthcare service to its patients well into the 21st Century. Ease of access, prompt courteous service and responsiveness to our patients' concerns will always be their primary goal. Pediatric Associates has continued to thrive and today is recognized as one of the premier general pediatric and population health management practices in the United States.

 

Join Our Talent Community

Submit your information below to be considered for future roles as they become available.

Join Now

Videos

Learn more about what it's like to work for Pediatric Associates from our very own employees. Our video library will give you insight to our culture and more!

View Now