Overview

The Senior Cost of Care Analyst provides organization-wide decision support via data mining, report and analysis configuration, data stewardship, project management, and customer service. This position works closely with both internal and external stakeholders in a consultative role to assess medical expense trends, health plan cost savings initiatives, vendor ROIs, and member service utilization. It requires the ability to query data, interpret findings, and configure easily consumed results for a large and varying customer audience.

This role is part of the Cost of Care Analytics team. This position will analyze and report medical expense trends, support medical expense cost-saving initiatives, assess the viability of vendor partnerships, complete ROI analyses, and support SIU and strategic expansion goals.

Requires the ability to data mine, interpret, understand, and summarize payer data, including (but not limited to) medical, behavioral health, and pharmacy claims, as well as clinical, financial, member, and provider information. This position will also create summaries, reports, and dashboards using various methodologies in an effort to provide clear and concise information for stakeholder decision support. Requires excellent oral and written communication skills.

Primary Responsibilities:

• Data mine and analyze insurance payer claims, as well as member and provider data from disparate sources using multiple criteria within the context of specified projects.
• Identify and analyze medical expense trends within inpatient, outpatient, professional, and pharmacy claims data/utilization.
• Assist cost of care stakeholders with health plan cost-saving initiative ideation through data stewardship and adoption.
• Analyze prospective and actual medical cost savings using multiple methodologies and calculations to determine health plan initiative viability.
• Review prospective vendor contracts and provide analytics-driven return on investment assessments.
• Create static and dynamic reports/analyses in diverse media for a broad customer audience, including organizational leadership.
• Prepare ad-hoc analyses and reports as required.
• Lead multiple analytic projects from initiative creation to closure, including deadline setting, customer management, and communication, and issue resolution.
• Onboard new team members and provide guidance and mentorship to junior analysts.

Education

• Bachelor's Degree (Required)

Certification/Licensure

• No specific certification or licensure requirements

Experience

• Required to have at least 3 years of experience in data analytics.
• Required to have advanced skills in Microsoft Excel
• Required to have advanced skills in SQL – writing queries and reporting.
• Required to have experience working in payer claims data, analyzing claims data
• Strongly preferred to have experience building dashboards in Tableau
• Prefer to have experience building dashboards in Power BI.
• Prefer to have experience in Databricks.

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