Role Description The Healthcare Analyst II VBR is responsible for analyzing healthcare utilization to identify patterns, variation, and outliers as well as identify and quantify opportunities to reduce medical costs.

• Analyze healthcare utilization to identify patterns, variation, and outliers
• Identify and quantify opportunities to reduce medical costs within the markets
• Evaluate the effectiveness of medical cost reduction initiatives
• Develop tools to efficiently compare market performance across and within products
• Provide analysis and recommendations to inform network provider performance improvement
• Monitor the efficiency and efficacy of clinical programs, interventions and processes
• Support the intake, prioritization and coordinated execution of ad-hoc analytics requests from departments across the organization
• Identify the variables and methodologies (e.g., qualitative, quantitative, spatial) that define population cohorts that can be positively impacted through targeted programs and interventions
• Segment population data to gain holistic intelligence via longitudinal trend analyses and advanced cluster analyses
• Conduct root cause analyses of adverse population health outcomes based on demographic, socioeconomic and clinical factors
• Perform any other job duties as requested

Qualifications

• Bachelor’s Degree or equivalent years of relevant work experience is required
• Minimum of two (2) years of experience in healthcare analytics is required
• Managed care experience is strongly preferred

Requirements

• Knowledge of healthcare data, including medical and pharmacy claims, EMR data, HIE data, UM data and demographic data
• Knowledge of Medicaid, Medicare and other government sponsored healthcare programs is preferred
• Proficient in Excel, Word and PowerPoint
• Proficient with Transact-SQL or SAS or Microsoft Power BI or Tableau
• Ability to organize data in a way that facilitates inferences, conclusions and decisions
• Demonstrated written and verbal communication skills

Benefits

• Compensation Range: $72,200.00 - $115,500.00
• In addition to base compensation, you may qualify for a bonus tied to company and individual performance.
• We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

Company Description

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.