Senior Health Plan Operations Analyst Job Listing at MedStar Health in MD (Job ID 161405)

Description

About the Job

General Summary of Position
Defines develops and prepares reports dashboards and analysis to support organization's goal of providing executive leadership with actionable intelligence related to the financial clinical and analytical performance. Provides specialized analytics and data driven insights to assist in developing recommendations for process improvement identifying trends and identifying root cause analysis. Collaborates with various areas to operationalize process improvements and mitigates/resolves negative trends in operational and clinical data.This position requires a thorough understanding of departmental and clinical operations data modeling and programmatic methodologies.

Primary Duties and Responsibilities

• Bachelor's degree in Healthcare Administration Finance Information Technology Business Adminsitration or related field required

• 5-7 years Experience in managed care or healthcare accounting finance analytics project leadership or related experience. required
• 5-7 years Experience in relational database management and analysis experience in Excel ODBC SQL SSRS and SISS reporting Tableau reporting and care management systems required

• Certified Tableau Specialist Tableau certification preferred
• SQL certification preferred

• An in-depth understanding of national reimbursement mechanisms (CMS-1500 UB forms ICD-10 PPS CPT HCPCS) as well as local regulatory environment.
• Strong understanding of operational activities around claims enrollment call center utilization management etc. related data.
• Extensive database experience (SQL coding experience preferred) with ability to access and manipulate significant amounts of complex data to produce meaningful and useful reports for senior management.
• Experience in advanced statistical models business intelligence tools risk adjustment methodologies and data visualization software strongly preferred.
• Tableau experience is preferred but not required.
• Ability to convey verbal and written information effectively.
• Ability to follow verbal and written instructions.
• Verbal and written communication skills.
• Computer skills preferred.