Manager of Analytics
JOB
Summary:
Manage daily operations of the health data analytics department. Manage the development, implementation, and maintenance of health data analytics policies, procedures and programs. Manage the production and development of utilization and cost containment information. Oversee the analysis and preparation of outcomes using healthcare claims data, pharmacy data, and lab data. ESSENTIAL JOB FUNCTIONS:
Responsible for performance and development of HEDIS measures, HEDIS reports, the preparation of documents required for auditors, and providing analytical support for ongoing abstraction of medical records Manages the generation of Quality dashboard, provider level star reporting and ad hoc analyses related to Medicare Star rating Support Quality program leadership in leading the build out of quality incentive program methodology into viable models underlying provider performance expectation and payout Provides summary analysis on various quality measures and health education by planning, collecting, and analyzing data, and by writing SQL and SAS code to extract appropriate data sets Maintains professional and technical knowledge by attending conferences, workshops; reviewing professional publications; establishing personal networks; participating in professional societies Develop operational processes, protocols, workflow documentation, and overall quality assurance controls for analytics team to adhere to Provide direction and technical guidance to staff. Set goals, review and evaluate work, and prepare performance reviews. Serve as departmental representative on various committees and at meetings with internal departments. Represent the corporation at external meetings. Perform other duties as assigned.
Qualifications:
Minimum Education and
Experience:
Bachelor's degree in Computer Science, Mathematics, Economics or related field; or an equivalent combination of education and experience Five or more years of health data analysis, business analysis, software application, database design, and technical documentation experience, preferably in the health insurance industry Three to five years management experience; or experience leading a team Preferred Education, Additional Qualifications and
Experience:
Knowledge of applied statistics Knowledge of econometric modeling HIAA certification Required Knowledge, Skills, and/or Abilities:
Knowledge of claims processing and membership processing for all BCBSRI lines of business Knowledge of CPT-4 and ICD-9 coding and covered benefits Understanding of SAS programming, spreadsheet, and database software and other application development tools Knowledge of general mathematical principals Working knowledge of Business Objects and Windows Understanding of micro and mainframe computer systems Skills related to computer programming as demonstrated by passing the Wolfe Spence Programming test Ability to coach and motivate to maximize performance Ability to effectively communicate goals and business objectives to employees Strong and effective decision-making skills Strong organization and time management skills Proficiency with Microsoft Suite of products (i.e., Word, Excel, PPT, etc.) Ability to effectively interact with all levels of the organization Ability to effectively delegate work and manage project tasks Excellent verbal and written communication skills, with ability to convey complex or technical information in an effective manner Ability to convert business strategy into action oriented objectives and measurable results Strong negotiating, influencing, and consensus-building skills
Salary Range:
$100K -- $150K
Minimum Qualification
Business Intelligence & AnalyticsEstimated Salary: $20 to $28 per hour based on qualifications.
Summary:
Manage daily operations of the health data analytics department. Manage the development, implementation, and maintenance of health data analytics policies, procedures and programs. Manage the production and development of utilization and cost containment information. Oversee the analysis and preparation of outcomes using healthcare claims data, pharmacy data, and lab data. ESSENTIAL JOB FUNCTIONS:
Responsible for performance and development of HEDIS measures, HEDIS reports, the preparation of documents required for auditors, and providing analytical support for ongoing abstraction of medical records Manages the generation of Quality dashboard, provider level star reporting and ad hoc analyses related to Medicare Star rating Support Quality program leadership in leading the build out of quality incentive program methodology into viable models underlying provider performance expectation and payout Provides summary analysis on various quality measures and health education by planning, collecting, and analyzing data, and by writing SQL and SAS code to extract appropriate data sets Maintains professional and technical knowledge by attending conferences, workshops; reviewing professional publications; establishing personal networks; participating in professional societies Develop operational processes, protocols, workflow documentation, and overall quality assurance controls for analytics team to adhere to Provide direction and technical guidance to staff. Set goals, review and evaluate work, and prepare performance reviews. Serve as departmental representative on various committees and at meetings with internal departments. Represent the corporation at external meetings. Perform other duties as assigned.
Qualifications:
Minimum Education and
Experience:
Bachelor's degree in Computer Science, Mathematics, Economics or related field; or an equivalent combination of education and experience Five or more years of health data analysis, business analysis, software application, database design, and technical documentation experience, preferably in the health insurance industry Three to five years management experience; or experience leading a team Preferred Education, Additional Qualifications and
Experience:
Knowledge of applied statistics Knowledge of econometric modeling HIAA certification Required Knowledge, Skills, and/or Abilities:
Knowledge of claims processing and membership processing for all BCBSRI lines of business Knowledge of CPT-4 and ICD-9 coding and covered benefits Understanding of SAS programming, spreadsheet, and database software and other application development tools Knowledge of general mathematical principals Working knowledge of Business Objects and Windows Understanding of micro and mainframe computer systems Skills related to computer programming as demonstrated by passing the Wolfe Spence Programming test Ability to coach and motivate to maximize performance Ability to effectively communicate goals and business objectives to employees Strong and effective decision-making skills Strong organization and time management skills Proficiency with Microsoft Suite of products (i.e., Word, Excel, PPT, etc.) Ability to effectively interact with all levels of the organization Ability to effectively delegate work and manage project tasks Excellent verbal and written communication skills, with ability to convey complex or technical information in an effective manner Ability to convert business strategy into action oriented objectives and measurable results Strong negotiating, influencing, and consensus-building skills
Salary Range:
$100K -- $150K
Minimum Qualification
Business Intelligence & AnalyticsEstimated Salary: $20 to $28 per hour based on qualifications.
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