Healthcare Analyst II

Job Summary Job Summary: The Healthcare Analyst II is responsible for analyzing healthcare utilization to identify patterns, variation, and outliers as well as identify and quantify opportunities to reduce medical costs. Essential Functions Essential Functions: 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 (e.g., qualitative, quantitative, spatial) 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 Education and Experience Education and Experience: Bachelor’s Degree or equivalent years of relevant work experience is required Minimum of two (2) years of experience in healthcare analytics is required Managed care experience is strongly preferred Competencies, Knowledge and Skills Competencies, Knowledge and Skills: 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 with 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 Working Conditions Working Conditions: General office environment; may be required to sit or stand for extended periods of time Compensation Range Compensation Range: $72,200.00 - $115,500.00 CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package. Compensation Type (hourly/salary): Salary Organization Level Competencies Fostering a Collaborative Workplace Culture Cultivate Partnerships Develop Self and Others Drive Execution Influence Others Pursue Personal Excellence Understand the Business Equal Opportunity CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds. Additional Information This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. #LI-EM1 Brand=CareSource Mission Statement The CareSource mission is known as our heartbeat. Just as we support our members to be the best version of themselves, our employees are driven by our mission to create a better world for members, stakeholders and providers. We are difference-makers who combine compassionate hearts with our unique business expertise to make every opportunity count. Each claim, each phone call, each consumer-centric decision is a chance to change the world for one member, and our employees look for ways to do that every day. The challenge is, there is no one right way to be the difference and we’re looking for people like you that will rewrite that definition every day. We do what it takes to form creative solutions that make our community and the world just a little better. Discover what it means to be #UniquelyCareSource. #J-18808-Ljbffr