Sr. Healthcare Data Analyst (Remote)

Sentara Health Plan is currently hiring a Sr.
Healthcare Data Analyst! This is a Full-Time position with day shift hours and great benefits! Work Location: Remote opportunities available in the following states: Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington (state), West Virginia, Wisconsin, Wyoming Job Responsibilities This role is part of the Cost of Care Analytics team.
This position will analyze and report medical expense trends, support medical expense cost saving initiatives, assess the viability of vendor partnerships, complete ROI analyses, and support SIU and strategic expansion goals.
Requires the ability to data mine, interpret, understand, and summarize payer data including (but not limited to) medical, behavioral health, and pharmacy claims, as well as clinical, financial, member, and provider information.
This position will also create summaries, reports, and dashboards using various methodologies in an effort to provide clear and concise information for stakeholder decision support.
Requires excellent oral and written communication skills.
-Data mine and analyze insurance payer claims, as well as member and provider data from disparate sources using multiple criterion within the context of specified projects.
-Identify and analyze medical expense trends within inpatient, outpatient, professional, and pharmacy claims data/utilization.
-Assist cost of care stakeholders with health plan cost saving initiative ideation through data stewardship and adoption.
Job Requirements: Required- Bachelor's degree.
Data Analysis - 5 years, Healthcare – 3 years SQL, Tableau, Excel Preferred: Experience in payer claims data Benefits: Sentara offers an attractive array of full-time benefits to include Medical, Dental, Vision, Paid Time Off, Sick, Tuition Reimbursement, a 401k/403B, 401a, Performance Plus Bonus, Career Advancement Opportunities, Work Perks, and more.
Sentara Healthcare offers employees comprehensive health care and retirement benefits designed with you and your family's well-being in mind.
Our benefits packages are designed to change with you by meeting your needs now and anticipating what comes next.
You have a variety of options for medical, dental and vision insurance, life insurance, disability and voluntary benefits as well as Paid Time Off in the form of sick time, vacation time and paid parental leave.
Team Members have the opportunity to earn an annual flat amount Bonus payment if established system and employee eligibility criteria is met.
For applicants within Washington State, the following hiring range will be applied: $87,477.
36 to $ 103,608.
96 annually.
Sentara Health Plans is the health insurance division of Sentara Healthcare doing business.
Sentara Health Plans provides health insurance coverage through a full suite of commercial products including consumer-driven, employee-owned and employer-sponsored plans, individual and family health plans, employee assistance plans and plans serving Medicare and Medicaid enrollees.
With more than 30 years’ experience in the insurance business and 20 years’ experience serving Medicaid populations, we offer programs to support members with chronic illnesses, customized wellness programs, and integrated clinical and behavioral health services – all to help our members improve their health.
Our success is supported by a family-friendly culture that encourages community involvement and creates unlimited opportunities for development and growth.
Be a part of an excellent healthcare organization that cares about our People, Quality, Patient Safety, Service, and Integrity.
Join a team that has a mission to improve health every day and a vision to be the healthcare choice of the communities that we serve! To apply, please go to www.
sentaracareers.
com and use the following as your Keyword Search: JR-31818 #Indeed Indeed Monster Talroo – Health Plan Talroo Keywords: Medical expense, cost of care, Insurance company, Medical expense trend, SQL, Tableau, Excel, Power BI, Healthcare, Health Plan, in-patient, out-patient, pharmacy, professional claims, cost savings, medical cost savings, cost savings initiatives, ROI, Member utilization, Claims utilization.
Care management data.
Ad-hoc reporting, Authorizations, Claims, Providers, Benefits.
Remote, Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington (state), West Virginia, Wisconsin, Wyoming The Healthcare Data Analyst Senior provides data analysis support to the customer by assisting with the development of reports and/or dashboards to monitor program and operational performance.
Promotes self-service analytics for customer adoption, understanding and use of data.
Supports design of programmatic analyses and reporting capabilities in addition to business requirement definition for new analyses and performs ad-hoc analysis as directed.
This position supports data quality and data stewardship functions to maintain data accuracy and identify new metrics.
As a subject matter expert, the Healthcare Data Analyst Senior uses analytic skills to offer data-driven conclusions and recommendations to business partners.
As an integrated health system, Sentara delivers analytics across a wide variety of domains, including payer functions, ambulatory, acute & post-acute care and support functions.
The subject matter expertise required will vary based on the specific opening, but include the following: -Medical expense and trends -Quality including HEDIS reporting, interventions, and STAR ratings -Clinical gaps and adherence -Network Management contracting and pay-for-performance/value-based measures -State and Federal regulatory reporting -Employer groups reporting and client ad-hoc reporting related to clinical and financial services -Population health reporting & analysis -Risk, member/patient stratification, member/patient segmentation, quality, provider scoring, and cost savings -Predictive analytics -Ambulatory, acute & post-acute quality, clinical performance, and operations reporting & analysis -Quality & performance benchmarking -Research data & analytic support Works directly with internal customers and external provider partners.
The Healthcare Data Analyst Senior on-boards new team members, and provides guidance and mentorship to junior analysts.
Knowledge of SQL and Tableau Excellent Oral and Written Communication Skills Problem Solving Consultative Engagement Skills The Senior Cost of Care Analyst provides organization-wide decision support via data mining, report and analysis configuration, data stewardship, project management, and customer service.
This position works closely with both internal and external stakeholders in a consultative role to assess medical expense trends, health plan cost savings initiatives, vendor ROIs, and member service utilization.
It requires the ability to query data, interpret findings, and configure easily consumed results for a large and varying customer audience.
Bachelor's Level Degree Master's Level Degree Data Analysis 3 years Financial Analysis 1 year Population Management 1 year Statistics 1 year Active Learning Active Listening Communication Complex Problem Solving Coordination Critical Thinking Reading Comprehension Service Orientation Time Management Troubleshooting Writing