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15086 Requisition #
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“Commercial Analytics” area is comprised of the below three core teams:

 
Risk and Care Analytics
  • Provides analytical support and insights to drive strategy, ensure compliance, and evaluate effectiveness of revenue program initiatives and campaign operations in support of the Affordable Care Act (ACA) Risk Adjustment program
  • Conducts analysis to support clinical care operations (medical and pharmacy), customer segmentation, and actionable results and insights that improve the health of our members
Provider Performance
  • Provides analysis in support of provider contracting strategies/negotiations and financial performance including impact of network acquisitions, terminations, and contractual arrangements
  • Examines and monitors provider performance and trends in support of forecasting, pricing, and product development
Value Based Providers
  • Develops analytics to drive opportunities on alternative payment programs or value based programs, including but not limited to Accountable Care Organization’s and Patient Centered Medical Homes
  • Negotiates/Develops contracts, report on arrangements, and support provider relationships in support of forecasting, pricing, and product development
 
The Health Business Analyst will assist the analytics with providing insight, analysis and
maintaining analytical findings. They will be Accountable for identifying and quantifying key drivers for the Health Business, investigating areas of opportunity, evaluating effectiveness and making recommendations.
 
The Skills You Bring
  • Analyze data and use analytical tools and techniques
  • Analyze or assist in the analysis of processes and programs in achieving stated goals. Provide analyses and recommendations if corrections are needed. Investigates and discovers areas of opportunity
  • Monitor and evaluate patterns, costs and trends
  • Produce basic spreadsheets, documents and presentations that are well-documented and easy to follow (e.g., Excel and PowerPoint).
  • Write basic SAS and/or SQL programs for data extraction. Modifies existing programs for data extraction.
  • Proactively seeks training and builds knowledge/experience of tools, languages and data sources.
 
Required Skills:
  • 2+ years related work experience or equivalent combination of transferable experience and education.
  • Master’s degree in relevant filed can be substituted for work experience requirement.
  • Bachelor's degree required
  • Experience with analytics and inferential statistics.
  • Experience writing SQL or SAS code or related code
 
Preferred Skills:
  • Bachelor’s degree Business Analytics, Health Economics or similar program
  • Master’s degree in a related field
 

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