Incumbent is responsibly for providing market-embedded thought leadership, competitive financial analysis and statistical studies for areas with considerable potential ROI, which may include: market encounter data, Medicaid risk adjustment optimization, member auto assignment opportunity and Medicaid quality incentive maximization. Leads the development of complex reporting and analysis, aimed at identifying root cause and trend identification which can be translated into actionable ROI for the market, division and/or product. Leverages strong public policy knowledge to translate complex data sets into meaningful, competitive analysis.
Department:Executive - Operations
Reports to:VP, State Operations
Location: Manhattan, NY
- Serves as an embedded, market-based leader for driving favorable encounter data inventory outcomes via partnership with shared services encounter teams, sophisticated analytical ability (including a robust understanding of multiple, complex data sources) and the ability to translate findings into actionable solutions that drive favorable business outcomes.
- Researches, analyzes, crafts and operationalizes strategies to drive market optimization in areas included: encounters, Medicaid Risk Adjustment, Medicaid Quality Incentives and Auto Assignment.
- Develops ad-hoc reports to conduct data analysis and validation for areas impacting market performance.
- Effectively partners with departments within both the market(s) and shared services, including actuarial, provider relations, claims and encounters to lead targeted projects and drive results.
- Researches methodologies and conducts advanced metric reporting by leveraging direct reports and/or matrix organizations (including market and shared services partners).
- Leverages outstanding ability to analyzes trends and translate findings into sound recommended process and/or operational improvements for business leaders.
- Prepare detail and summary level reports including written interpretation of analytic results.
- Capitalizes upon solid knowledge of public policy to provide evidenced-based, data-driven thought leadership to market, divisional and product executive teams via outstanding written and oral communication skills.
- Evaluates financial impact of implemented initiatives.
- Performs other duties as assigned.
- Required A Bachelor's Degree in Public Policy, Statistics, Mathematics, or relevant field
- Preferred A Master's Degree in MBA, Masters in Public Policy, Statistics, Mathematics or relevant field
- Required 7 years of experience in a related analysis role supporting business departments
- Required 7 years of experience in preferably in a Healthcare or public policy environment
Licenses and Certifications:
- Intermediate Demonstrated written communication skills
- Intermediate Demonstrated interpersonal/verbal communication skills
- Intermediate Ability to analyze information and covert related activities into a comprehensive work plan
- Intermediate Ability to work as part of a team
- Intermediate Ability to work independently
- Intermediate Ability to work within tight timeframes and meet strict deadlines
- Intermediate Demonstrated organizational skills
- Intermediate Other Ability to remain calm under pressure
- Intermediate Other Ability to work overtime as required
A license in one of the following is required:
- Required Intermediate Microsoft Outlook
- Required Intermediate Microsoft Word
- Required Intermediate Microsoft PowerPoint
- Required Advanced Microsoft Excel
- Required Advanced Microsoft Access
- Preferred Intermediate Other May require knowledge of one or more of the following: SQL, Crystal, Diamond, Cognos, CRMS, PC, Sidewinder
- Preferred Intermediate Statistical Analysis Systems (SAS)