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This position will extract, analyze and interpret data to produce both standard claims and utilization trend reporting and ad hoc analysis requests. Supports all functions within Medical Economics including monitoring of specific corporate and health quality & affordability initiatives. (HQAI's).
Supports research and analysis of financial data, draws conclusions and provides consultation to internal and external partners for use in administering specific programs and processes related to medical expense and utilization.
Creates comparative views of unit cost information that Market and Shared Service contracting teams can utilize to identify outlier contracts.
Conducts ongoing monitoring of medical cost savings initiatives.
Supports the business units to identify trend outliers, analyze the trend drivers and perform the work necessary to facilitate the discussion on possible solutions.
Performs detailed analyses, including accumulation of data, financial modeling, and reporting of outcomes.
Provides detailed analytics to provider network contracting teams in support of the negotiation process.
Develops ad hoc views of data that illustrates underlying trend issues for both cost and utilization.
Performs additional duties as assigned.
Required A Bachelor's Degree in Health Care Decision Support related
Required or equivalent work experience equaling 2 additional years of experience listed below
Required 2 years of experience in SAS Enterprise Guide, SQL, or other graphical business intelligence tools
Intermediate Ability to identify basic problems and procedural irregularities, collect data, establish facts, and draw valid conclusions
Intermediate Ability to work in a fast paced environment with changing priorities
Intermediate Demonstrated organizational skills
Intermediate Other Ability to interpret an extensive variety of technical instructions
Intermediate Other Ability to remain calm under pressure
Intermediate Ability to effectively present information and respond to questions from peers and management
Licenses and Certifications: A license in one of the following is required:
Required Intermediate Microsoft Word
Required Intermediate Microsoft Outlook
Required Intermediate Microsoft Excel
Preferred Intermediate Other Knowledge of database concepts and designs
Preferred Intermediate Other SAS Enterprise Guide / SQL