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Position Summary
Fast growing Medicare Advantage health maintenance organization is looking to add a strong and dynamic Health Data Analyst.
The Health Data Analyst provides analytical and project management support to the Director of Stars Strategy and Health Programs. This position will also contribute to the other departments within the division including Population Health/Case Management, Pharmacy Management, Utilization Management (UM), and Quality Improvement.
Essential Duties and Responsibilities
Quality Improvement
- Support HEDIS program management including vendor oversight, audit activities, chart abstraction projects and prospective projects.
- Request medical records for various quality initiatives.
- Support Star ratings including Medication adherence rates improvement activities.
- Assist QI committees’ efforts by setting-up required meetings, developing agendas and minutes.
- Assist in analyzing EHR data, claims and pharmacy data to evaluate performance on quality metrics and communicate insights through presentations and reports.
Pharmacy
- Interact with the PBM on various reports and analysis to support quality initiatives.
- Download and analyze Acumen PDE reports.
- Provide data analysis to ensure quality assurance for Medicare Part D EOBs
- Perform analysis on medication adherence members data to identify opportunities for improvement
All Departments
- Enhance data analytics for and across departments to improve on Triple AIM goals.
- Create and update the key performance indicators (KPIs) dashboard for division.
- Assist internal partners and vendors with letter development, updates, implementation, and maintenance.
- Research, compile and distribute required reports based on project priorities.
- Partner with IT team to submit business request documents and develop reports.
Education, Experience and Qualifications
- Bachelor’s degree in analytical discipline
- At least three (3) year of health analytics related experience – Medicare, Stars or HEDIS preferred.
Knowledge, Skills and Abilities
- Excellent communication and analytical skills, including writing, critical-thinking, and the ability to work with others in a collaborative fashion.
- Advanced computer skills and demonstrated use of Microsoft products, including Outlook, Access, Excel, Word, PowerPoint, Power BI
- Working knowledge of health insurance and claims processing activities.
- Proficiency with database programming languages such as SQL
- Ability to adapt to change and able to take and follow through with delegated tasks
Physical Requirements
- Please see Exhibit A
Computer Skills
- Proficiency utilizing Microsoft Office to include Word, Excel, Access, power point.
Affirmative Action/EEO statement
The Company provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
Other duties
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.
Exhibit A
Checklist: Job Analysis/Job Description Physical Activities
Physical Activities
Ascending or descending ladders, stairs, scaffolding, ramps, poles and the like.
☒ Never ☐ Occasionally ☐ Constantly
Moving self in different positions to accomplish tasks in various environments including tight and confined spaces.
☒ Never ☐ Occasionally ☐ Constantly
Remaining in a stationary position, often standing or sitting for prolonged periods.☐Never ☐Occasionally ☒ Constantly
Moving about to accomplish tasks or moving from one worksite to another.☒ Never ☐ Occasionally ☐ Constantly
Adjusting or moving objects up to 15 pounds in all directions.☐ Never ☒ Occasionally ☐ Constantly
Communicating with others to exchange information.☐ Never ☐ Occasionally ☒ Constantly
Repeating motions that may include the wrists, hands and/or fingers.☐ Never ☐ Occasionally ☒ Constantly
Operating machinery and/or power tools.☒ Never ☐ Occasionally ☐ Constantly
Operating motor vehicles or heavy equipment.☒ Never ☐ Occasionally ☐ Constantly
Assessing the accuracy, neatness and thoroughness of the work assigned.☐ Never ☐ Occasionally ☒ Constantly
Environmental Conditions
Low temperatures.☒ Never ☐ Occasionally ☐ Constantly
High temperatures.☒ Never ☐ Occasionally ☐ Constantly
Outdoor elements such as precipitation and wind.☒ Never ☐ Occasionally ☐ Constantly
Noisy environments.☐ Never ☒ Occasionally ☐ Constantly
Hazardous conditions.☒ Never ☐ Occasionally ☐ Constantly
Poor ventilation.
☒ Never ☐ Occasionally ☐ Constantly
Small and/or enclosed spaces.☒ Never ☐ Occasionally ☐ Constantly
No adverse environmental conditions expected.
☒ Never ☐ Occasionally ☐ Constantly
Physical Demands
Sedentary work that primarily involves sitting/standing.
☐ Never ☐ Occasionally ☒ Constantly
Light work that includes moving objects up to 20 pounds.
☐ Never ☒ Occasionally ☐ Constantly
Medium work that includes moving objects up to 50 pounds.
☒ Never ☐ Occasionally ☐ Constantly
Heavy work that includes moving objects up to 100 pounds or more.
☒ Never ☐ Occasionally ☐ Constantly
Pay: $80,000.00 – $125,000.00 per year
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Disability insurance
- Employee assistance program
- Flexible spending account
- Health insurance
- Health savings account
- Life insurance
- Paid time off
- Vision insurance
Work Location: Remote
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