Operations Data Analyst

Job Description

Job Description

Position Summary:

The Operations Data Analyst role: is responsible for collecting, organizing, analyzing, validating, and maintaining Provider, Member, Claims and other Operational data, as well as developing automation processes and tools for the Operations Departments.

This role will regularly assist with improving and refining the analytics, using a verity of tools. The Operations Data Analyst will assist in solving complex problems with cross-functional business partners, to support ongoing workflow enhancements for various projects and enhance the organization’s overall efficiencies. This position is expected to have a thorough understanding of the business process and be able to work independently.

Essential Duties and Responsibilities:

1. Assists in solving complex problems with cross-functional business partners both internally and externally to assist ongoing workflow enhancements.
2. Assists in improving and refining analysis techniques using various tools that include, but may not be limited to, Excel/Access/SQL/PowerBi.
3. Supports strategic positioning for provider contracting, assists in the development of networks and helps identify opportunities for greater value-orientation.
4. Supports provider credentialing and provider data management effectiveness.
5. Contributes to the development of alternative network initiatives.
6. Analyzes data to develop solutions to operational problems and recommend changes.
7. Will support initiatives that improve total medical cost reductions.
8. Prepares, analyzes, reviews, and projects the financial impact of reports.
9. Prepares contractual reporting for all Operations Departments.
10. Creates monthly reports to management on key findings and recommendations.
11. Review company policies and business process.
12. Assists in the development, review, and presentation of annual audits.
13. Works independently with minimal guidance.
14. Manages multiple projects simultaneously and has time-management and organizational skills.

This job description in no way states or implies that these are the only duties performed by the employee occupying this position. Employees will be required to perform any other job-related duties assigned by their supervisor or management.

Qualifications:  

• Bachelor’s degree in related area preferred
• 3-5 years of healthcare industry experience preferred
• Experience with data analysis tools, e.g., MS Office applications, SQL and/PowerBI - required
• EPIC or other health information management system experience, preferred

Skills and Abilities:  

• Strong verbal/written communication skills – English
• Good interpersonal skills to work with different management levels
• High proficiency in Microsoft Office applications 
• SQL and/or PowerBI
• Analytical Problem-Solving Customer centric and interpersonal skills - required
• Quantitative skills and ability to perform data analysis and problem solving
• Demonstrate experience and passion in challenging problem and driving outstanding results
• Analytical and highly organized - able to work and lead projects with little supervision
• Motivated to successfully meet deadlines
• Ability to prepare and present concepts and proposals to all levels of management
• Team player with proven ability to develop strong working relationships in a fast- paced environment
• Demonstrates an ability to maneuver effectively in a changing environment

Work Schedule:

Community Care Plan is currently following a hybrid work schedule. The company reserves the right to change the work schedules based on the company needs.

  Physical Demands: 

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to sit, use hands, reach with hands and arms, and talk or hear. The employee is frequently required to stand, walk, and sit. The employee is occasionally required to stoop, kneel, crouch or crawl. The employee may occasionally lift and/or move up to 15 pounds.

Work Environment: 

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of the job. The environment includes work inside/outside the office, travel to other offices, as well as domestic travel. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually moderate.

We are an equal opportunity employer who recruits, employs, trains, compensates and promotes regardless of age, color, disability, ethnicity, family or marital status, gender identity or expression, language, national origin, physical and mental ability, political affiliation, race, religion, sexual orientation, socio-economic status, veteran status, and other characteristics that make our employees unique. We are committed to fostering, cultivating, and preserving a culture of diversity, equity, and inclusion.

Background Screening Notice:
In compliance with Florida law, candidates selected for this position must complete a Level 2 background screening through the Florida Care Provider Background Screening Clearinghouse.

The Clearinghouse is a statewide system managed by the Agency for Health Care Administration (AHCA) and is designed to help protect children, seniors, and other vulnerable populations while streamlining the screening process for employers and applicants. Additional information is available at: ???? h