Senior Data Analyst, Clinical Programs

🕒 Maio 23

🤠 Texas – Remoto

🤠 Texas – Remote

⏰ Tempo Integral

🟠 Sênior

📉 Analista de Dados

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Brighton Health Plan Solutions

SiteLinkedInTodas as Vagas

201 - 500 funcionários

⚕️ Seguro de Saúde

☁️ SaaS

Healthcare Insurance • SaaS

A Brighton Health Plan Solutions é uma empresa de habilitação em saúde que está transformando o cenário da saúde por meio de tecnologia inovadora e planos de saúde personalizados. Com mais de 30 anos de experiência em administração terceirizada, a empresa se especializa em gestão de planos de saúde, contratação direta para empregadores e benefícios adicionais integrados. A Brighton Health Plan Solutions oferece plataformas tecnológicas avançadas para simplificar tarefas administrativas e melhorar o engajamento dos membros. Eles atuam como um elo crucial na contratação direta entre grupos e sistemas de saúde, oferecendo expertise em administração e contratação de provedores. Ao alinhar as partes interessadas e criar produtos de planos de saúde flexíveis, eles buscam melhorar a prestação de serviços de saúde e os resultados.

Descrição

• Monitor Utilization Management and Case Management activities through the development of KPIs and benchmarks (i.e. member engagement rates, readmissions, preventable hospitalizations, ER utilization) • Develop statistical models that deliver meaningful insights on cost, utilization and clinical outcomes based on various data sources. • Develop algorithms for stratifying populations and identifying high-risk members. • Leverage Predictive Analytics to measure the performance (ROI) of Disease Management and other Medical Management programs. • Conduct prospective savings analyses in support of clinical program initiatives. • Build and maintain client-facing reports, dashboards, and analyses. • Develop actionable data insights and advise on client strategy. • Participate in program performance review presentations with clinical program managers, client account managers, and external clients, as needed. • Manage internal and external client requests and timelines to ensure timely delivery. • Collaborate with Medical Management to provide ongoing support.

🎯 Requisitos

• Bachelors' degree required, preferably in Mathematics, Statistics, Finance, Actuarial Science, Data Science, or related field. • 5-7 years of experience in healthcare analytics, preferably in a managed care setting. • Proficiency in SQL and Microsoft SQL Server Suite of Products (SSMS) required. • Proficiency in MS Excel required. • Advanced data analysis, financial modeling, and predictive analytics skills. • Experience with clinical program evaluation and outcomes reporting. • Experience with health plan performance reporting and cost and utilization analysis. • Experience with developing client-facing reports. • Experience with Business Intelligence applications and DAX functions (PowerPivot, Power BI, Tableau). • Ability to explain technical concepts to a non-technical audience. • Ability to effectively manage and prioritize several concurrent projects. • Excellent oral and written communications skills. • Experience with Payer Care Management platforms (i.e. ZeOmega) a plus.

🏖️ Benefícios

• Health insurance • 401(k) matching • Flexible work hours • Paid time off