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DUTIES: -Provide the organization with critical information to make fact-based decisions, including building a strong business alignment with internal customers. -Manage business analysts to produce operational reports by state and product to management teams, and continuously identify processes to automate/eliminate reports by applying business process improvement and process reengineering to report development. -Work with internal report production teams to evaluate historical performance and forecast future performance by obtaining agreement with stakeholders on key assumptions and risks, in order to design and build utilization management dashboards/reports/models, and interpret and create final recommendations. -Improve the data quality using data analytical tools such as Excel, SQL, SAS or similar analytical tools. -Develop systematic reports using tools such as SSRS and Tableau. -Analyze claims, provider network, and clinical data recommendations in terms of cost and utilization. -Develop internal applications and systems for claims auditing. -Build market data warehouse to perform network modeling for contract negotiations. -Retrieve and research data to design and delivery analytical information to support business needs such as capitation. -A/R, utilization and claims validation. -Build and manage the work track system and provide KPI's to management.
REQUIREMENTS: Bachelor's degree or equivalent combination of education and experience in Information Technology, or related field.5 years of experience in Analytics or related.Required experience must include 1 year of management experience in an analytical team environment. Also requires experience with the following: project management; SQL and/or SAS in a healthcare data analysis environment; SSRS or Tableau and Data Transformation tool (SSIS); data warehouse systems such as SSAS; Rational Database Management System (SQL Server and/or Oracle); Xcelys and QXNT domain applications; and Microsoft Analysis Services for data warehousing.