PURPOSE AND SCOPE:
Responsible for transforming data into analytical insights to inform decisions for both internal and external stakeholders. Works with healthcare claims data to generate measures of quality, cost and utilization of care. Comfortable working with large databases using tools such as SQL/SAS, and creates reports and dashboards using Tableau or other reporting tools
PRINCIPAL DUTIES AND RESPONSIBILITIES:
Ensures data integrity is maintained throughout the reporting lifecycle.
Implements reporting and reconciliation workflows and document processes.
Responsible for experience studies and medical trend studies.
Responsible for running queries and providing required analysis in order to understand related drivers (such as medical cost and utilization), as well as providing insightful commentary and sensitivity modeling analysis.
Reports production to support financial reporting and operations.
Pulls ad-hoc reporting as needed.
Performs research and collection of data, including data mining and reporting, which is provided to various internal and external partners.
Refers to senior level staff for assistance with high level problems that arise.
Develops and test interim solutions, manages basic process changes, as needed, evaluates and monitors results making the appropriate changes/improvements as applicable.
Automates manual reporting and analysis of business implication and trends.
Drives efforts to continually improve data capabilities and quality of department analysis and reporting.
Development of revenue and medical claims expense models for evaluating and projecting risk based contracts with health plan clients, ACOs and government partners.
In depth claims of baseline and ongoing contract monthly data.
Profitability analysis and drill down analysis into actual expected variances.
Assists with various projects as assigned by direct supervisor.
Performs other duties as assigned.
PHYSICAL DEMANDS AND WORKING CONDITIONS:
- The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Little to no travel is expected for this position.
- Bachelor's Degree; Advanced Degree desirable or an equivalent combination of education and experience
EXPERIENCE AND REQUIRED SKILLS:
- 2- 5 years of related experience.
- Strong computer skills with demonstrated proficiency in word processing, spreadsheet, presentation, database and email applications.
- Strong interpersonal skills with the ability to collaborate with multiple departments.
- Excellent oral and written communication skills to effectively communicate with all levels of management.
- Pursuing ASA designation
EO/AA Employer: Minorities/Females/Veterans/Disability/Sexual Orientation/Gender Identity
Fresenius Medical Care North America maintains a drug-free workplace in accordance with applicable federal and state laws.
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