Population Health Data Analyst Senior

Job Profile Summary  

This individual will be responsible for analyzing complex clinical and financial (claims-based) scenarios to support informed decision making. This person works relatively independently with limited direction and supervision. Responsible for gathering and interpreting claims, clinical and administrative data to build effective financial models, make reasonable assumptions, and reach appropriate conclusions. Serves as a resource and consultant across the system and sites to design and produce relevant information to inform strategies essential to the success of population health initiatives. 

Job Description  

Major Responsibilities: 

• Prepares analyses and develops routine and special management reports and reporting tools to support ongoing PHO, CIN, RBO operations, finance, care management, clinical risk adjustment, and department management decision making. Works with administrative and physician leadership (site and system). 

• Analyze the total cost of care and payer contract performance using any and all data systems available. Makes specific recommendations to management and physician leadership (site and system) based on the results of these analyses. Analyze clinical, financial, and quality performance by site, physician, and contract. Proactively identify areas for analyses and share information with physician and administrative leadership. 

• Conduct and present analyses that drive improved delivery of value-based care. 

• Works with IT partners to diagnose, correct, and validate any issues with the data populating business intelligence tools. 

• Creates efficient presentations of quantitative and qualitative information by minimizing text and appropriately incorporating visual displays. For executive level reports, craft a concise written summary of key report conclusions and clearly translate analyses and visualizations into practical and actionable recommendations. Summarizes analytical findings in ways that business leaders and front-line clinicians can quickly understand and use to drive performance improvement. 

• Assumes responsibility for maintaining current knowledge of government regulations, policies, and trends that affect the health care industry, and independently conduct online research to access documents, pertinent regulations, or to access publicly available datasets. 

Licensure, Registration, and/or Certification Required: 

• None Required. 

Education Required: 

• Bachelor's Degree in Accounting or related field, or 

• Bachelor's Degree in Business, or 

• Bachelor's Degree in Health Care Administration, or 

• Bachelor's Degree in Computer Science. 

Experience Required: 

• Typically requires 5 years of experience in clinical data analysis or analytics experience in health insurance or healthcare fields. 

Knowledge, Skills & Abilities Required: 

Must have strong analytical skills, advanced Microsoft Office Suite skills specifically in Excel and PowerPoint, and be able to communicate effectively with management and staff at all levels. 

• Advanced analytical skills, including the ability to analyze quantitative and qualitative data and reach sound conclusions. 

• Advanced computer skills, including Microsoft Office Suite; especially Excel. 

• Experience with one or more business intelligence tools (e.g. PowerBI, Business Objects, Strata). 

• Good communication skills, including verbal communication and business writing. 

• Working knowledge in the healthcare insurance industry, healthcare finances, care management, clinical risk adjustment, and/or physician practices. 

• Good project management and time management skills. 

• Good interpersonal skills, including the ability to communicate at all levels within the organization. 

• Experience with EMRs (Electronic Medical Records) preferred. 

• Experience and ability to create complex queries in SQL or other query languages. 

• Ability to code in Python preferred. 

Physical Requirements and Working Conditions: 

• Position may require some travel. May be exposed to road and weather hazards. 

• Generally exposed to normal office environment. 

• Operates all equipment necessary to perform the job. 

This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. The incumbent may be required to perform other related duties.