Associate Provider Data Analyst

5 days ago

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Highmark Health

WebsiteLinkedInAll Job Openings

health care

10,000+

💰 $5M Grant on 2021-05

Description

• JOB SUMMARY ***CANDIDATE MUST BE US Citizen (due to contractual/access requirements)*** • The incumbent works closely with internal customers responsible for the design and operations of enterprise value based reimbursement programs. • Has an understanding of key provider reimbursement concepts and the ability to communicate those concepts effectively. • Delivers analytics and insights to key decision-makers to help guide and design programs and initiatives. • Performs data modeling and partners with data management staff to work efficiently and capitalize on data automation opportunities. • Reports on value based reimbursement program outcomes, trends, and drivers to improve financial performance. • Develops internal-facing provider reports/analytic tools to highlight key performance indicators for value based reimbursement programs and trend drivers of overall financial/quality performance. • Designs basic scorecards and dashboards using analytic tools to support value based reimbursement arrangements with large strategic partners in the market. • Supports the creation of value based reimbursement programs across the enterprise including initiatives for PCPs, specialists, facilities, post-acute providers, and ancillary providers. • Interprets raw claims, provider, quality, and member data to build data sets to be used for analytic and reporting purposes. • Assists with provider cost savings analyses related to value based reimbursement and understands how return on investment impacts the enterprise and the provider. • Reports on financial outcomes of value based provider arrangements and provider incentives to accurately reflect the financial position. • Interacts with stakeholders in a manner that fosters cooperation and teamwork while conveying engagement and competence. • Provides responsive service and understands customer needs.

Requirements

• Required Relevant analytic work experience • Insurance or healthcare work experience • Preferred None