Position Title: Data Analyst IV Medical Economics
Work Location: Remote.
Assignment Duration: Full-Time
Work Schedule: This position will support mostly CST/EST - if this candidate is PST, they will be expected to work 6-3p PST (8-5 CST or 9-6 EST)

Note:
This position will support mostly CST/EST - if this candidate is PST, they will be expected to work 6-3p p.m. PST (8-5 CST or 9-6 EST) REMOTE US (please no HI or AK at this time due to time zone)

Position Summary: Responsible for analytic data needs of the business unit. Handle complex data projects and acts as a lead for other Data Analysts.

Key Responsibilities:

• Provide advanced analytical support for business operations in all or some of the following areas: claims, provider data, member data, clinical data, HEDIS, pharmacy, external reporting
• Extract, load, model, and reconcile large amounts of data across multiple system platforms and sources
• Review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management
• Develop reports and deliverables and make recommendations to management
• Model data using MS Excel, Access, SQL, and/or other data ware house analytical tools
• Assist management in driving business decisions based on data
• Ensure compliance with federal and state deliverable reporting requirements by performing data quality audits and analysis
• Assist with training and mentoring other Data Analysts
• Assist with determining work load and related activities for other Data Analysts
• Performs other duties as assigned
• Complies with all policies and standards

Qualification & Experience:

• Bachelor’s degree in business, economics, statistics, mathematics, actuarial science, public health, health informatics, healthcare administration, finance or related field or equivalent experience. Master's degree preferred. 5+ years of experience working with large databases, data verification, and data management or 3+ years IT experience. Healthcare analytics experience preferred. Experience with table creation and indexing, query optimization, and utilization of stored procedures. Working knowledge of SQL/querying languages. Experience with table creation and indexing, query optimization, and utilization of stored procedures. Preferred knowledge of programmatic coding languages such as Python and R. Knowledge of statistical, analytical, or data mining techniques including basic data modeling, trend analysis, and root-cause analysis preferred. Preferred knowledge of modern business intelligence and visualization tools. Experience in emerging trend analysis, financial modeling, claims pricing, contract/network analysis, and/or ROI evaluation preferred. Familiarity with claims payment, utilization management, provider/vendor contracts, risk adjustment for government sponsored healthcare desired.
• Bachelor’s degree in business, economics, statistics, mathematics, actuarial science, public health, health informatics, healthcare administration, finance or related field or equivalent experience. Master's degree preferred. 5+ years of experience working with large databases, data verification, and data management
• Experience with Medicare, Medicaid and Marketplace analytics Strong SQL skills, including the ability to write and understand complex queries, SELECT statements, and multiple types of JOINs. Advanced Excel skills, including: Pivot Tables Power Query VLOOKUP / XLOOKUP Averages, aggregations, formatting Creating and nesting formulas to build metrics and perform financial modeling Power BI experience, with familiarity in DAX and Power Pivot. Experience with financial analytics tools and basic financial modeling/sizing Strong understanding of payment methodologies, including DRG pricing, APC, and EAPG payment methodologies
• Python and R Collaborate with cross-functional teams to evaluate QAI (Quality and Affordability Initiatives), MLR (Medical Loss Ratio) targets, and related key performance indicators (KPIs)
• 5+ years of experience
• Managed Care Analytics - payment methodologies - Medical Economics (Healthcare)
• Bachelors degree or equivalent experience - with Bachelors 5 years of experience Without Bachelors degree - must have 9 years of experience

 
 
At SPECTRAFORCE, we are committed to maintaining a workplace that ensures fair compensation and wage transparency in adherence with all applicable state and local laws. This position’s starting pay is: $ 100000.00/Yearly.