Full-Time Health Data Specialist

Job Description

Serves as the key data management, acquisition and analysis resource for clinical operations. Utilizing a high level of independent judgment and discretion, specific responsibilities include, but are not limited to: specifying, producing, and analyzing a standard set of process and outcome metrics, census reports and utilization data on a regular basis to support routine assessment of the market, subsets of the market, providing guidance and leadership to data analysis effort, health/behavioral problems, and quality of care measures of the plan population to initiate quality improvement studies, provide proof points to the customers, and support demonstration of return on investment. Also responsible for handling the completion of ad hoc requests from start to finish including meeting with requestor, mining the data from the appropriate warehouse and delivering a quality final product to the customer..* Use of process and outcome metric results for population based analysis to identify gaps in care, cost drivers and areas of service opportunity in all program categories.

* Work closely with matrix partners (Clinical Operations, IM&T, Finance, Pricing, and Clinical Quality Improvement) to develop data and analytical capabilities to perform analyses on quality improvement and value added/ROI strategies.

* Support the development of metrics, structure of studies, benchmark initiatives, and data collection methodologies.

* Assist with the evaluation of current and future company strategies with data.

* Perform routine and ad hoc (Drill-Down) analysis as it relates to program development, execution and evaluation processes.

* Works productively in an environment that requires constant development of technical data skill sets including SAS, SQL, COGNOS, Hyperion, Toad, Microsoft Access, and Excel..

Requirements

* Self-starter with analytical skills in a matrix organization required.

* Ability to take direction and support the business objectives and technology as well as underlying data required supporting product needs.

* Analytical experience required.

* Experience in the health care/managed care environment required.

Knowledge

* Bachelors degree in Business, Economics, Health Policy Analysis, Finance or Healthcare Administration required.
* 1-2 plus years experience in health care/managed care with direct responsibility for analysis is required.
* Strong communication skills to include both written and oral skills.
* Understanding of managed care business processes.
* Technical ability with relational database concepts and applications, specifically use COGNOS, Hyperion, SQL, SAS, MS Access, Toad and Excel. Expertise in SQL and at least two of these applications is required in order to be considered for this position.
* Proven ability to work independently while managing multiple tasks and meeting deadlines.
* Knowledge of standard medical claims or coding: CPT, ICD9, and HCPC is required..