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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 Sr Health Business Analyst will be accountable for identifying and quantifying key drivers for the Health Business, investigating areas of opportunity, evaluating effectiveness and making recommendations. The Senior Health Business Analyst is relied upon to apply business knowledge to Analytics projects and provide value-added insights to directly impact business outcomes.
The Skill You Bring
  • 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
  • May assist in training other team members on basic technical skills
Required Skills:
  • 4+ years related work experience or equivalent combination of transferable experience and education. Experience Details:
  • Bachelor's degree required
    Master’s degree or equivalent work experience relevant field can be substituted for 2 years’ work experience
  • Experience with analytics and inferential statistics.
    Intermediate level experience writing SQL /SAS or related code
    Advanced Excel skills (ability to create and use pivot tables and formulas)

Preferred Skills:
  • Bachelor’s degree Business Analytics, Health Economics or similar program
  • Master’s degree in a related field

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