Senior Health Business Analyst - Medicare

15224 Requisition #
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Job Summary
Develops analysis, insights, and reports in support of Medicare Advantage provider network contracting. Assesses financial performance and unit cost trends of hospital and physician networks, including evaluating the impact of network acquisitions, terminations, strategic initiatives, and changes to reimbursement terms. Communicates results of analysis to leadership to aid in strategy development, forecasting, pricing, competitiveness, and product development. The Senior Medicare Health Business Analyst is relied upon to apply business knowledge to Analytics projects and provide value-added insights to directly impact business outcomes. Accountable for identifying and quantifying key drivers for the Health Business, investigating areas of opportunity, evaluating effectiveness and making recommendations.
Essential Functions
  • The essential functions listed represent the major duties of this role, additional duties may be assigned.
  • Manipulate data using large datasets and multiple data sources
  • Act as primary Analyst for assigned projects and proactively identify topics for analysis
  • 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
  • Develop Excel-based models and spreadsheets containing advanced functions that are used to evaluate historical trends and forecasts and to identify best practices.
  • Write SAS and/or SQL programs for data extraction. Modifies existing programs for data extraction
  • Accountable for developing insightful and actionable summaries and recommending actions
  • May assist in training other team members on basic technical skills
Required Work Experience

4+ years related work experience or equivalent combination of transferable experience and education.
Additional Required Qualifications

Experience with analytics and inferential statistics.
Intermediate level experience writing SQL or related code
Advanced Excel skills (ability to analyze and summarize large amounts of data create and use pivot tables and formulas)
Proficient with Microsoft Office products
Ability to manage tasks independently, take ownership of responsibilities and meet deadlines
Strong written and oral communication skills
High critical thinking skills to evaluate alternatives and present solutions that are consistent with business objectives and strategy
Preferred Qualifaications

Bachelor’s degree Business Analytics, Health Economics, Mathematics, Statistics, or similar program
Master’s degree in a related field
Experience with Medicare Advantage and/or other health insurance provider contracts (e.g., knowledge of DRG, per diem, fee schedule reimbursement methodologies)
General Physical Demands
Sedentary work: Exerting up to 10 pounds of force occasionally to move objects. Jobs are sedentary if traversing activities are required only occasionally.
Incidental Driving
We are an Equal Opportunity Employer/Protected Veteran/Disabled.


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