Health Plan Data Analyst III (Health Plan & Provider experience a must)

Job Summary:

The Health Plan Data Analyst III is responsible for extracting, analyzing, reporting, tracking and monitoring provider data across business functions, systems and interfaces. Additional responsibilities include analyzing data operations to support building new solutions and enhancing performance of existing solutions primarily in provider space and other areas as required.

Essential Functions:

• Manage new HPLC initiatives from concept to implementation and provide statistics measuring progress
• Participate as a member of Health Partner Lifecycle (HPLC) team to support existing provider data operations and new market implementations
• Perform cost-benefit and return on investment analyses for proposed initiatives to aid in the decision-making process; collect and analyze data in support of business case creation and realization
• Ensure operational effectiveness by assisting in the development of strategic plans for HPLC, including business, financial, and operational goals and objectives; recognize and manage scope and expected outcomes across the HPLC’s strategic initiatives and process improvements
• Assume a leading role in the operational readiness process by reviewing transitional activities and associated documentation for completion prior to initiative implementation, including operational reports, turnover documentation, departmental policies and procedures and job aids
• Assume a leading role in the review of reports and data for pattern identification, special cause variation identification, trend analysis, or other techniques; prepare and deliver summaries, recommendations, or alternatives of the analyzed information.
• Develop, document and perform testing and validation as needed
• Mentor peers to achieve cross-functional capability with project execution and subject matter expertise
• Challenge the standard thinking with new ideas, approaches, and solutions which focus on process improvement and growth
• Act as Subject Matter Expert for provider data and impacts to downstream processes
• Perform any other job related duties, as requested

Education and Experience:

• Bachelor’s degree or equivalent years of relevant work experience is required
• Minimum of five (5) years of health care data analysis or project management experience is required
• Experience with Cognizant Facets Provider application is required
• Six Sigma or other performance improvement experience is preferred
• Managed care experience is preferred

Competencies, Knowledge and Skills:

• Proficient in Microsoft Office products including Word and Excel
• Strong knowledge and understanding of Facets data model
• Knowledge of regulatory reporting and compliance requirements
• Demonstrated excellent analysis and supporting technical skills to include SQL/Access capabilities
• Ability to manage projects exhibiting excellent organizational and collaboration skills
• Ability to effectively interact with all levels of management within the organization and across multiple organizational layers
• Effective problem solving skills with attention to detail
• Time management skills, ability to develop, prioritize and accomplish goals with a sense of urgency
• Ability to multi-task and remain flexible during organizational and/or business changes
• Exceptional communication (verbal and written), facilitation and presentation skills
• Strong interpersonal, leadership and relationship building skills
• Critical listening and thinking skills
• Effective time management and prioritization skills
• Decision making and problem solving skills

Licensure and Certification:

• None

Working Conditions:

• General office environment; may be required to sit or stand for extended periods of time

Compensation Range:

CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type (hourly/salary):

Organization Level Competencies

• Fostering a Collaborative Workplace Culture

• Cultivate Partnerships

• Develop Self and Others

• Drive Execution

• Influence Others

• Pursue Personal Excellence

• Understand the Business

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.

Originally posted on Himalayas