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Employment Type:

Full time

Shift:

Day Shift

Description:

Successful candidates will have knowledge of Health Plans in decision support, data analytics, or governmental or managed care reimbursement.

Why MediGold?

MediGold (https://medigold.com/) is a not-for-profit Medicare Advantage insurance plan serving seniors and other Medicare beneficiaries across the United States. We’re dedicated to providing excellent customer service, cost-effective care, and exceptional healthcare coverage. We rely on talented colleagues in a wide variety of professional roles including information technology, financial analysis, audit, provider relations and more.

About the job:

Senior Decision Support Analyst for the Health Plan works with in conjunction with fellow Analysts and Director to provide analysis and dashboard reporting for leaders across the organization. This position is responsible for providing analytics to the departmental customers (internal & external) to assist in decision making processes and updating monthly data validation and reporting.

What we are looking for:

+ **Education** : Bachelor’s degree in business, accounting, finance, health informatics or related field, or experience in lieu of a degree (minimum 4 years related work experience).

+ **Experience** : Five or more years’ experience in a finance setting (healthcare preferred) in one of the following areas: decision support, data analytics, or governmental or managed care reimbursement.

+ A high degree of analytical ability and critical thinking skills.

+ Ability to translate complex data sets into descriptive reports and presentations understandable to leadership, associates, and external customers.

+ Ability to work independently with high level of initiative and complete projects according to established timelines.

+ Knowledge of health plan operations (claims, revenue, or risk adjustment) preferred.

+ Advanced MS Excel skills.

+ Experience working with business intelligence tools, Tableau and/or Business Objects is highly preferred.

+ Experience loading, validating, and querying data in SAS environment is preferred.

+ Experience reading and writing code in Base SAS, SAS Enterprise Guide and/or SQL is preferred.

What you will do:

+ Maintain in-depth understanding of health plan operations and healthcare analytics.

+ Provide quantitative and qualitative analytics, developing correlations between various activity measures, cost, revenue, and utilization metrics to support performance improvement.

+ Under general supervision, performs research and analysis of complex health care claims, pharmacy, and lab data regarding network utilization and cost containment information.

+ Evaluates, writes, presents, and provides recommendations regarding health care utilization and cost containment reports.

+ Identify, analyze, and interpret trends or patterns in complex data sets. Responsible for compiling, analyzing, trending, tracking, and interpreting all operational, clinical, business and financial activities of the Plan and is responsible for analyzing business goals, objectives and needs of the business.

+ Develop and maintain customized dashboard reporting. Provide consistent, timely and accurate reporting.

+ Write database queries to extract data as needed for projects to support the needs of leadership.

+ Provides both operational support to, and analysis of, all plan activities, facilitates quality and performance improvement efforts and activities within the day-to-day business operations and supports project implementation, and coordination and refinement of business process, and champions an environment of continuous process improvement

+ Requires a high degree of business focus with the ability to ensure that the functional requirements and the design support the business requirements.

+ Often the liaison between business and technical team to provide technical solutions, processes, system configurations and resolutions and works with all departments, especially MIS, Finance, Administrative, Claims, UR/QA, and Medical Management.

+ Performs all assigned month-end responsibilities with a high level of accuracy and minimal supervision in accordance with the established department schedule.

+ All other duties as assigned.

Position Highlights and Benefits:

+ Competitive compensation and benefits packages including medical, dental, and vision with coverage starting on day one.

+ Retirement savings account with employer match starting on day one.

+ Generous paid time off programs.

+ Employee recognition programs.

+ Tuition/professional development reimbursement.

+ Relocation assistance (geographic and position restrictions apply).

+ Discounted tuition and enrollment opportunities at the Mount Carmel College of Nursing.

+ Employee Referral Rewards program.

+ Mount Carmel offers DailyPay - if you’re hired as an eligible colleague, you’ll be able to see how much you’ve made every day and transfer your money any time before payday. You deserve to get paid every day!

+ Opportunity to join Diversity, Equity, and Inclusion Colleague Resource Groups.

Ministry/Facility Information:

Mount Carmel, a member of Trinity Health, has been a transforming healing presence in Central Ohio for over 135 years. Mount Carmel serves over 1.3 million patients each year at our four hospitals, free-standing emergency centers, outpatient facilities, surgery centers, urgent care centers, primary care and specialty care physician offices, community outreach sites and homes across the region. Mount Carmel College of Nursing offers one of Ohio's largest undergraduate, graduate, and doctor of nursing programs. If you’re seeking a rewarding career where your purpose, passion, and desire to make a difference come alive, we invite you to consider joining our team. Here, care is provided by all of us For All of You!

_Mount Carmel and all its affiliates are proud to be equal opportunity employers._ _We do not discriminate on the basis of race, gender, religion, physical disability or any other classification protected under local, state or federal law._

Our Commitment to Diversity and Inclusion

Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law.

Our Commitment to Diversity and Inclusion

Trinity Health is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians across 25 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions.

Our dedication to diversity includes a unified workforce (through training and education, recruitment, retention, and development), commitment and accountability, communication, community partnerships, and supplier diversity.

EOE including disability/veteran