Senior Healthcare Analyst at Tufts Associated Health Plans in Watertown, MA

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Description

We enjoy the important work we do every day on behalf of our members.

Job Summary

Under the oversight of the Senior Manager of Provider Reporting on the Contract Strategy & Analytics team, the Senior Health Care Analyst will provide analytic support to produce Risk and other Reporting deliverables, primarily for the Commercial provider partners. The Senior Health Care Analyst will work closely with all levels of Commercial Contracting staff to produce financial reporting in support of our contracts and contract negotiations. The position requires the ability to translate complex contractual reimbursement terms into an easily understandable and articulate format.

Essential functions occur simultaneously and sometimes with very short turn-around time. Therefore, the employee must be able to appropriately handle each essential function, prioritize them with minimal direction, and seek assistance when necessary. These functions need to be performed on a consistent and regular basis, using good judgment.

This is a senior analytical and technical position and as such, must be able to perform independently and execute and/or oversee all the analytical and technical tasks required to take a project from inception to completion.

A thorough understanding of the health insurance industry with proficiency in relational databases, data warehouses, Excel and financial modeling, as well as strong interpersonal skills, is required.

Job Description

KEY RESPONSIBILITIES & ESSENTIAL FUNCTIONS

  • Perform data generation, analysis and modeling to support contractual commitments by required deadline
  • Perform analysis and modeling required to support various strategic initiatives related to reimbursement models, provider reporting and collaboration, network design, and regulatory compliance
  • Develop various ad-hoc analyses as required
  • Project management responsibilities owning projects from start to finish. This will include defining project needs, creating a methodology, conducting the analysis or delegating work to junior analysts, and presenting findings. This position will require managing project timelines, and communicating the project status.
  • Participation in meetings/committees as department subject matter expert
  • Works with other members of the team to identify and act on opportunities to improve quality and efficiency

JOB QUALIFICATIONS: KNOWLEDGE/SKILLS/ABILITIES

EDUCATION: (Minimum education & certifications required)

  • Bachelor's Degree required; Master's degree preferred.

EXPERIENCE: (Years of experience)

  • This position requires 3-5 years of work experience.
  • Advanced analytic abilities are required.
  • Proficiency in the use of PC based computers is essential.
  • Previous experience in a managed care or provider setting is strongly preferred.
  • The position requires knowledge of health care reimbursement methodologies.
  • Expertise in SAS, Tableau, or any otherunderstanding ofrelational databases and large data structures is required.
  • Proficiency with Excel, Word and PowerPoint is also necessary.
  • Requires excellent interpersonal skills to work with a diversity of individuals from numerous departments and different levels within the organization.
  • Requires excellent oral and written communication skills.

SKILL REQUIREMENTS: (Include interpersonal skills)

  • Must be able to work cooperatively as a team member both within the department and externally to other departments or outside the company.
  • Interacts independently with all levels of Tufts Health Plan management, staff, physicians, hospital administrative personnel, academic researchers, and outside vendors.

    Management

  • Provide training and mentorship to analysts onteam
  • Provide strategic input

    Technical

  • Ability to interpret contract language relative to reporting requirements.
    Ability to design, build and maintain complex technical applications.

    Analysis/Interpretation

  • Demonstrated experience in analytic project design.
  • Develops analyses, examines and interprets results in the context of the specific provider questions being addressed.
  • Analyzes trends, investigates unusual results and offers explanations.

    Independence/Judgment

  • Receives regular management oversight of selected tasks, projects and processes
  • Applies own judgment on most analytical and technical issues, with input on organization and implementation.

    WORKING CONDITIONS AND ADDITIONAL REQUIREMENTS (include special requirements, e.g., lifting, travel,

    overtime)

  • Fast paced office environment handling multiple demands.
  • Must be able to exercise appropriate judgment as necessary.
  • Works on a personal computer approximately 80% of the time.
  • Participates in internal and interdepartmental meetings approximately 20% of the time.

Requirements

EDUCATION: (Minimum education & certifications required)

  • Bachelor's Degree required; Master's degree preferred.

EXPERIENCE: (Years of experience)

  • This position requires 3-5 years of work experience.
  • Advanced analytic abilities are required.
  • Proficiency in the use of PC based computers is essential.
  • Previous experience in a managed care or provider setting is strongly preferred.
  • The position requires knowledge of health care reimbursement methodologies.
  • Expertise in SAS, Tableau, or any otherunderstanding ofrelational databases and large data structures is required.
  • Proficiency with Excel, Word and PowerPoint is also necessary.
  • Requires excellent interpersonal skills to work with a diversity of individuals from numerous departments and different levels within the organization.
  • Requires excellent oral and written communication skills.

SKILL REQUIREMENTS: (Include interpersonal skills)

  • Must be able to work cooperatively as a team member both within the department and externally to other departments or outside the company.
  • Interacts independently with all levels of Tufts Health Plan management, staff, physicians, hospital administrative personnel, academic researchers, and outside vendors.

    Management

  • Provide training and mentorship to analysts onteam
  • Provide strategic input

    Technical

  • Ability to interpret contract language relative to reporting requirements.
    Ability to design, build and maintain complex technical applications.

    Analysis/Interpretation

  • Demonstrated experience in analytic project design.
  • Develops analyses, examines and interprets results in the context of the specific provider questions being addressed.
  • Analyzes trends, investigates unusual results and offers explanations.

    Independence/Judgment

  • Receives regular management oversight of selected tasks, projects and processes
  • Applies own judgment on most analytical and technical issues, with input on organization and implementation.

    WORKING CONDITIONS AND ADDITIONAL REQUIREMENTS (include special requirements, e.g., lifting, travel,

    overtime)

  • Fast paced office environment handling multiple demands.
  • Must be able to exercise appropriate judgment as necessary.
  • Works on a personal computer approximately 80% of the time.
  • Participates in internal and interdepartmental meetings approximately 20% of the time.

What we build together changes our customer's health for the better.We are looking for talented and innovative people to join our team.Come join us!

PDN-TAHPR852

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