Health Plan Data Analyst III, Health Plan & Provider Experience

Job not on LinkedIn

🕒 Yesterday

🇺🇸 United States – Remote

💵 $72.2k - $115.5k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

📉 Data Analyst

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CareSource

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 30+ years

⚕️ Healthcare Insurance

Healthcare Insurance

CareSource is a health services company focused on providing affordable health insurance and healthcare solutions. It offers a wide range of plans including Medicaid, Marketplace, and Medicare Advantage, targeting low-income adults, families, children, pregnant women, elderly adults, and people with disabilities. Additionally, CareSource provides members with resources for COVID-19 support, dental, vision, and hearing benefits, as well as pharmacy services. The company emphasizes easy access to healthcare management through online platforms and a mobile app.

📋 Description

• 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

🎯 Requirements

• 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 • 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

🏖️ Benefits

• comprehensive total rewards package