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 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.

Bachelor’s Degree or equivalent years of relevant work experience
Minimum of two (2) years of experience in healthcare analytics
Managed care experience is strongly preferred
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 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.

Healthcare Analyst II

Key skills