Provides data analysis and projected utilization and costs for all lines of business and sub-groupings in aggregate for appropriate action. Performs monthly analysis of actual utilization and cost trends and compares/adjusts projected rates. Performs quarterly data pulls for rebate submissions and reconciliations. Evaluates and identifies inappropriate prescribing patterns from prescription and medical claims data for potential action by appropriate personnel. Coordinates paid claims data transfer between MVP and PBM, performing quality checks. Performs studies on data on previous and current utilization including: ordering reports from IT; downloading data from mainframe to PC; utilize software such as Excel, Access, business objects, McSource, and PBM programs. Evaluates and tests data; validates data; creates charts/graphs; summarizes results both verbally and in writing; identifies impact to organization from results. Performs other duties as assigned.
Bachelor s Degree or equivalent combination of education and directly related experience will be considered
Minimum of 2-5 years of experience in data analysis and report development
2 years of work experience in healthcare/health insurance environment preferred
" Intermediate skills with Access and Excel
" Familiarity with downloading; word processing, database, and spreadsheet skills
" Exceptional organizational and strong written and verbal communication skills
" Superior attention to detail and strong project management skills
" Team player with ability to adapt to a fast-pace, changing environment.
" Ability to maintain confidentiality
" Knowledge of and working experience with Business Objects, Cognos
MVP Health Plan covers about 650,000 most valuable people. Also known as MVP Health Care, the company provides health insurance and employee...