• Sr Analyst, Managed Care Data

    Location US-CA-Monterey Park
    Job ID
    2018-6883
    Category
    Managed Care
  • Overview

    The Senior Analyst, Managed Care Data is responsible for managing the data that supports AltaMed’s managed care initiatives. The primary responsibility is the maintenance and enhancement of an integrated network of databases used to gather multiple sources of data, help the managed care department calculate incentive payouts, analyze the performance of each provider, and audit/reconcile health plan data submissions. Secondary responsibility is the production of analytical reports on provider health plan listings, provider performance, HCC/RAF and quality measures, and research of additional data sources that could benefit managed care operations. Position responsibilities can also include automation analyses and implementation, and providing data to help manage innovative projects and ideas.

     

    Responsibilities

    1. Integrates/interfaces data from AltaMed’s electronic health records, specialized software, and outside sources related to managed care operations, provider data management, provider performance, HCC/RAF, quality metrics, and incentive payouts into working databases.
    2. Uses MS access, SQL Server, and EA data to build queries, forms, and reports. Uses task scheduler to automate processes, data compiles, and daily tasks.
    3. Identifies low/high performing providers and programs alerts and notifications to appropriate departments/staff members.
    4. Analyzes complex business processes and provides SQL enabled process to enhance business practices or to improve data exchanges.
    5. Analyzes data from EZ-Cap and various managed care auxiliary data systems to create advanced data models.
    6. Assists Managed care team members by streamlining data collection and reporting sources to improve accuracy and efficiency.
    7. Enhances integrated network of MS Access databases to an SQL database while maintaining enterprise wide data collection and usage.
    8. Evaluates proprietary patient, clinical quality, financial performance, claims, and other data from AltaMed’s data warehouse and enterprise data systems for use in innovative projects.
    9. Leads and manages data analysis projects, including the use of quantitative or predictive analytics that support AltaMed’s integration, growth and maximizing value strategic initiatives.
    10. Reviews health policy and health care industry information sources to stay current and inform key stakeholders on emerging health care industry issues.
    11. Creates summary and detailed informational reports and presentations for AltaMed leadership and management to support business decisions that enable AltaMed to achieve its strategic goals and objectives.
    12. Cultivates and maintains partnerships and collaborations with internal and external business partners.
    13. Assists members of AltaMed’s Business Intelligence community and other departmental team members in accessing and analyzing health care data and information.
    14. Aptitude to learn and implement new programs and innovative projects efficiently.

    Qualifications

    1. Bachelor’s degree required. Healthcare related or an information technology field of study is preferred.
    2. A minimum of two (2) years of experience in analysis of health care operations, patient, clinical quality or financial data.
    3. A minimum of four (4) years of experience in reporting, aggregation, and transformation of data using SQL server

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