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011050 CCA-BI & Analytics

Position Summary:

The Sr. Associate II will lead Medical Economics data, reporting, and analytics. He/She will lead the activites on trend analytics and reporting and support monthly production activities within the Medical Economics department. The department makes extensive use of SAS and SQL programs to produce the data and analyses required to answer questions related to medical expenses, medical utilization, and premium revenue.

Supervision Exercised:

+ No, but it does mentor junior and offshore resources

Essential Duties & Responsibilities:

+ Utilize techniques and tools for data aggregation, descriptive analysis, visualization, and presentation to effectively communicate insights and recommendations about the drivers of medical expense and utilization.

+ Examine data to identify patterns and anomalies, offering thorough root cause analysis.

+ Develop ROI studies/analytics focusing on healthcare utilization and expense, aligning them with outcomes from clinical initiatives and external arrangements.

+ Outstanding communication and interpersonal abilities, adept at explaining complex technical concepts to non-technical stakeholders.

+ Collaborate directly with stakeholders from clinical, network contracting, claims, and medical management to understand their needs and determine how analytical solutions could help.

+ Develop presentation materials that articulate the problem statement, methodology, key takeaways, and recommendations for a diverse set of stakeholders ranging from senior leadership to line managers.

+ Coordinate with cross functional teams, including Business Intelligence, IT, Operations, Clinical and Medical Management

+ Mentor junior analysts and offshore staff.

Working Conditions:

+ Remote

Required Education:

+ BA/BS in Mathematics, Economics, Healthcare, or other quantitative discipline required

Required Experience:

+ Proficient comprehension of healthcare data and analytical approaches

+ Strong knowledge of health care claims data

+ Minimum of ten (10) years of experience in healthcare financial reporting and analytics is necessary.

+ Work experience with SAS, SQL, or Python in extracting, manipulating, and analyzing large datasets

+ Experience working with Excel with large datasets, VLOOKUP, pivot tables, and advanced functions/formulae

Required Knowledge, Skills & Abilities:

+ Strong organizational, analytic, and problem-solving skills

+ Work independently with support from Med Econ director and colleagues

+ Independent and self-motivated candidate who can drive a project from beginning to end

+ Basic understanding of Medicare and Medicaid programs

+ Interpersonal communication skills enabling the incumbent to collaborate effectively within department and across functions.

Language(s):

+ English

EEO is The Law

Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled

Please note employment with CCA is contingent upon acceptable professional references, a background check (including Mass CORI, employment, education, criminal check, and driving record, (if applicable)), an OIG Report and verification of a valid MA/RN license (if applicable). Commonwealth Care Alliance is an equal opportunity employer. Applicants are considered for positions without regard to veteran status, uniformed service member status, race, color, religion, sex, national origin, age, physical or mental disability, genetic information or any other category protected by applicable federal, state or local laws.