Healthcare Risk Analytics Analyst

MetroPlus; New York (NY); Hybrid; USD 75,000 - 120,000; Full time

Job summary

MetroPlusHealth in New York, NY seeks an Analytics Specialist to utilize the plan’s data to provide analysis and curated data extracts for financial, contracting, quality and reporting of health care services.

The role involves researching, collecting, analyzing and presenting utilization, quality and financial data, working with multiple departments to coordinate analytics and improve operational efficiency and data accuracy.

Qualifications

• Bachelor’s Degree or a minimum of 3 years of industry-related experience (business, health care, consulting, insurance, government).
• Insurance operations experience preferred.
• Proficiency in Microsoft Excel, Access and Word is necessary.
• SQL Query skill is desired.
• Experience with statistical systems and data reporting.

Responsibilities

• Execute, deliver and maintain pre-existing scheduled reporting processes.
• Work alongside the Lead Risk Analyst on report creation, delivery and troubleshooting.
• Assist in the preparation and delivery of data to be incorporated into pre-existing reporting mechanisms.
• Work with staff to prepare analyses on financial risk arrangements including value-based payments, revenues, expenses, utilization, quality, and membership over time.
• Ingest, format, and store information received by external departments and actuaries for integration into downstream reporting.
• Create, update and maintain documentation on processes impacting business workflows across departments to inform staff and identify areas for improvement.
• Support staff on initiatives pertaining to value-based contracting, finance, risk and quality.
• Prepare projection analyses on claims and utilization, including underlying trends and risk analysis.
• Prepare analyses of medical service from large, shared databases utilizing queries and multiple level extracts.
• Prepare financial analyses for providers based on their risk performance.
• Prepare financial historical and projection analyses for contracting proposals such as those related to value-based contracting.
• Ensure critical risk affiliations are represented in our data and work with IT staff to resolve issues/discrepancies.
• Act as a liaison with provider finance and operations staff.
• Special projects and other related duties as assigned.

Skills

Excel proficiency

Analytical thinking

Communication

Team collaboration

Education

Bachelor’s degree or 3+ years experience

Tools

Excel

Access

Word

SQL

Job description

MetroPlusHealth in New York, NY seeks an Analytics Specialist to utilize the plan’s data to provide analysis and curated data extracts for financial, contracting, quality and reporting of health care services.

The role involves researching, collecting, analyzing and presenting utilization, quality and financial data, working with multiple departments to coordinate analytics and improve operational efficiency and data accuracy.