Healthcare Analyst II is an individual contributor role that provides senior-level healthcare analysis for the state health plans, including quantification and analysis of health care costs, development and maintenance of databases and other sources of information for quality initiatives, accreditation efforts, and regulatory mandates, and claims data coordination.
Duties and Responsibilities:
Implement and use software and systems to support the department’s goals.
Create new databases and reporting tools for monitoring, tracking and trending based on project specifications.
Assist with research, development and completion of special projects as requested by various internal departments, or in support of requests from regulatory agencies, contracting agencies, or other external organizations.
Responsible for timely completion of projects, including timeline development and maintenance, and coordination of activities and data collection with requesting internal departments or external requestors.
Establish and maintain positive working relationships with internal customers and external vendors, including individuals who are supervised by others.
Provide leadership to other members of the team, including training of Healthcare Analyst I level personnel and internal customers.
Develop payment tracking and reporting setup for P4P Program.
Develop procedures for processing and distributing incentive payments to PCP’s.
Generate HEDIS compliant and non-compliant members report for all PCP’s.
Generate quarterly encounter data reports for PCP incentive payments.
Generate physician report cards using HEDIS measures.
Generate all other reports and data for P4P and HEDIS as needed.
All other duties as required.
Ability to manage various sources of information and large data sets including pharmacy, claims and encounter data
Proficiency in compiling data, creating reports and presenting information, including expertise with Crystal Reports (or similar reporting tool), SQL query, MS Access and MS Excel
Ability to combine clinical and financial data
Demonstrated ability to meet established deadlines
Ability to function independently and manage multiple projects
Ability to develop scenario analysis using different approaches
Ability to present ideas and information concisely to varied audiences
Proficiency with PC-based systems, and the ability to learn other systems through knowledge of MS Excel and Access
Excellent verbal and written communication skills
Bachelor’s Degree; or combination of relevant education and experience
Bachelor’s Degree in Math, Finance, Business or IS
4 years increasingly complex database and data management responsibilities
Basic knowledge of SQL
Healthcare Payer industry experience
Healthcare Analyst I or Financial/Accounting Analyst I experience desired
Multiple data systems and models
Molina Healthcare offers competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Molina Healthcare - 11 months ago
Navigating the murky waters of federal health care plans is no easy feat, but Molina Healthcare's mission is to help Medicaid and Medic...