Manager - Healthcare Analytics

Position Overview

We are seeking a highly skilled and analytical Manager - Healthcare Analytics to lead our data-driven initiatives, ensuring the seamless integration, validation, and reporting of healthcare data to meet both business and customer objectives. In this pivotal role, you will oversee the design of robust data models, analyze health risk segmentation, and uncover critical trends to enhance healthcare management and decision-making. Your expertise will be instrumental in transforming raw data into actionable insights, driving performance improvements, and supporting digital transformation initiatives across the organization.

Key Responsibilities

The Manager - Healthcare Analytics will be responsible for executing and delivering high-impact deliverables that analyze, validate, and standardize data-gathering processes. Your core responsibilities will include:

• Healthcare Data Analysis:
  • Design and implement data models that integrate patient data from multiple sources to create comprehensive health data views.
  • Conduct in-depth analysis of member health risk segmentation, including profiling for chronic conditions such as chronic disease, cancer, hepatic disease, and renal failure.
  • Identify patterns, trends, and correlations within healthcare data to inform strategic decision-making.
• Performance Analysis and Reporting:
  • Extract, integrate, and analyze data from diverse sources to support optimal healthcare management and decision-making.
  • Develop and publish monthly reports for mega accounts, incorporating multiple dimensions to provide actionable insights.
  • Create detailed reports and presentations to communicate findings to stakeholders at all levels of the organization.
  • Ensure the accurate and timely completion of daily and monthly performance metric reports.
  • Collaborate with management to translate analytical insights into strategic initiatives and operational improvements.
• Data Cleansing and Standardization:
  • Apply advanced categorization techniques to standardize service mapping and ensure data consistency.
  • Validate and standardize doctor names, specialties, and unified service coding processes to maintain data integrity.
• Transformation and Automation Initiatives:
  • Partner with cross-functional business units to execute objectives related to big data projects, digital enhancements, and system implementations.
  • Interpret and validate data to support the development of advanced analytics and machine learning models.
  • Automate manual reporting processes using Power BI to enhance efficiency and accuracy.

Required Skills and Qualifications

To excel in this role, the ideal candidate will possess the following qualifications and competencies:

• Experience: 2-4 years of experience in an analytical role, preferably within a healthcare provider or health insurance environment.
• Technical Proficiency: Intermediate to advanced skills in Microsoft Excel, PowerPoint, and Power BI, with a strong ability to manipulate healthcare claims data.
• Analytical Capabilities: Exceptional ability to interpret data at both high-level and granular levels, identifying trends and insights that drive informed decision-making.
• Communication Skills: Outstanding analytical and communication skills, with the ability to present complex data insights in a clear and compelling manner to diverse audiences.
• Education: Bachelor’s degree in Medicine and Surgery or Pharmacy.

Preferred Qualifications

While not mandatory, candidates with the following additional qualifications will be highly regarded:

• Experience with healthcare data standards such as ICD-10, CPT, or HCPCS.
• Familiarity with data visualization tools beyond Power BI, such as Tableau or Qlik.
• Knowledge of SQL and other database querying languages for data extraction and manipulation.
• Prior experience in leading digital transformation initiatives or implementing data-driven process improvements.

Join our dynamic team and play a pivotal role in shaping the future of healthcare analytics. Your expertise will directly contribute to improving patient outcomes, optimizing healthcare operations, and driving innovation within the organization.