Healthcare Analyst II

CareSource; United States; On-site; USD 72,000 - 116,000; Full time

Job summary

CareSource is seeking a Healthcare Analyst II to analyze healthcare utilization, identify patterns and outliers, and quantify opportunities to reduce medical costs. The role supports market-level cost reductions and evaluates initiatives for effectiveness, developing tools to compare performance and inform network provider improvements.

Ideal candidates have a Bachelor’s degree or equivalent experience with at least two years in healthcare analytics; managed care experience is preferred.

Qualifications

• Bachelor’s Degree or equivalent years of relevant work experience.
• Minimum of two years of experience in healthcare analytics.
• Managed care experience preferred.

Responsibilities

• Analyze healthcare utilization to identify patterns, variation, and outliers.
• Identify opportunities to reduce medical costs within the markets.
• Evaluate the effectiveness of medical cost reduction initiatives.
• Develop tools to compare market performance across and within products.
• Provide analysis and recommendations to inform network provider performance improvement.

Skills

Analytical thinking

Communication skills

Problem solving

Education

Bachelor’s Degree or equivalent years of relevant work experience

Tools

Transact-SQL

SAS

Power BI

Tableau

Job description

Job Summary

The Healthcare Analyst II is responsible for analyzing healthcare utilization to identify patterns, variation, and outliers as well as identify and quantify opportunities to reduce medical costs.

Essential Functions

• Analyze healthcare utilization to identify patterns, variation, and outliers
• Identify and quantify opportunities to reduce medical costs within the markets
• Evaluate the effectiveness of medical cost reduction initiatives
• Develop tools to efficiently compare market performance across and within products
• Provide analysis and recommendations to inform network provider performance improvement
• Monitor the efficiency and efficacy of clinical programs, interventions and processes
• Support the intake, prioritization and coordinated execution of ad‑hoc analytics requests from departments across the organization
• Identify the variables and methodologies (e.g., qualitative, quantitative, spatial) that define population cohorts that can be positively impacted through targeted programs and interventions
• Segment population data to gain holistic intelligence via longitudinal trend analyses and advanced cluster analyses
• Conduct root cause analyses of adverse population health outcomes based on demographic, socioeconomic and clinical factors
• Perform any other job duties as requested

Education And Experience

• Bachelor’s Degree or equivalent years of relevant work experience is required
• Minimum of two (2) years of experience in healthcare analytics is required
• Managed care experience is strongly preferred

Competencies, Knowledge And Skills

• Knowledge of healthcare data, including medical and pharmacy claims, EMR data, HIE data, UM data and demographic data
• Knowledge of Medicaid, Medicare and other government sponsored healthcare programs is preferred
• Proficient in with Excel, Word and PowerPoint
• Proficient with Transact‑SQL or SAS or Microsoft Power BI or Tableau
• Ability to organize data in a way that facilitates inferences, conclusions and decisions
• Demonstrated written and verbal communication skills

Working Conditions

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

$72,200.00 - $115,500.00 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.

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.