Healthcare Data Analyst
Healthcare Data AnalystAbout usCommon Ground Healthcare Cooperative is a who not a what.
As a cooperative, we are thousands of Wisconsin residents buying health insurance together, supported by a staff focused on providing the best possible service to our members.
We are a not-for-profit cooperative, governed by a Board of Directors made up of members who purchase our health insurance.
Any earnings are returned to our members in the form of lower prices and better services.
Our CultureWe are here because we can make a difference in the lives of others.
We believe that serving our community is meaningful work and we hold it in the highest regard.
We are vibrant, dynamic, and value-focused individuals who welcome different points of view, perspectives, and thoughtful solutions to challenges.
We encourage teamwork, integrity, mutual respect, honesty and doing the right thing.
We know the importance of showing appreciation for a job well done, celebrate our achievements, and make room for fun and laughter in the workplace.
Our JobWe are continuously improving our efforts to serve our members and lower their overall healthcare cost through our three key pillars:
Advocacy Partnership Innovation.
Does this sound like a culture you'd like to be a part of?Come join a fun team of committed professionals!How You'll Make a DifferenceThe Healthcare Data Analyst is responsible for performing sophisticated quantitative analyses for maintaining, and improving, the overall financial health and performance of the company.
These analyses will include risk-based capital forecasts; premium forecasting; financial performance by line of business, geographic area, and plan; budget forecasts; and claims analyses.
The claims-focused analyses will include those that focus on fraud, waste, and abuse; claims inventory; and analyses that identify improved utilization, or provider contracting, approaches.
The position will carry out analyses, and participate in decisions, regarding plan design, rate development, and creating financial models that will help the executive team to evaluate the ROI on new and different business propositions.
This position will report to the Director of Actuarial Services and will make significant contributions to the development and achievement of the company's strategic planning portfolio.
Strong collaboration with other departments within the company will be critical to the success of this position.
Utilize Your Skills By:
Combines data and information from multiple sources to analyze and draw conclusions about plan performance, including electronic health record, eligibility, or claims data.
Collects, analyzes, interprets, and presents comparative clinical and cost data, integrates benchmark information, and uses findings as a foundation for intervention and improvement.
Designs, develops, and continuously improves new and existing forecasting models and tools.
Creates and provides sound statistical analyses and frame business scenarios that are meaningful and have impact on critical business processes and/or decisions.
Conceptualizes and creates ad-hoc analyses, projects, and reports to assist in making appropriate business decisions and improvements.
Designs and enhances medical and pharmacy claim utilization, membership, and revenue reporting.
Analyzes key trends and performance related to clinical programs, provider network performance, other programs or practices, and providers of health care.
Develops new reports, tables, dashboards, and charts as needed, and assists with the maintenance of existing reports.
Supports, and enhances, both internal and external reporting around key financial metrics.
Collaborates with leaders across the plan to identify opportunities for improvement and best use of resources, anticipating business needs and proactively developing ideas and solutions to meet them.
Formulates data-based recommendations and effectively communicates them throughout the organization, providing explanations, information, and direction to business leaders regarding trends and forecasts.
Converts data-centered findings into recommended solutions, changes to business practices, and/or new opportunities.
Evaluates options and makes recommendations to business processes across the health plan to gain efficiencies and enhance performance.
Presents analytic trends and recommendations to all levels of the plan, including the ability to report findings to senior leadership.
Collaborates on written narrative summaries that outline analytical project purposes, methodologies employed, summary of findings, trends of interest, and opportunities for consideration.
Works on special projects as requested and all other duties as assigned.
What You'll Need to Bring:
Bachelor's Degree in statistics, mathematics, finance, accounting, or related field.
Experience working in a rapid cycle, decision support role, and very dynamic environment.
Advanced analytical skill set, including Excel skills is required, SQL programming is desired.
Ability to assist with, or support, risk adjustment systems and operations.
Experience integrating data sets from different sources and in different formats.
Ability to participate in strategic decision-making discussions.
Ability to handle multiple analysis projects simultaneously.
Ability to conceptualize, structure, perform, and interpret what if? Scenarios.
High comfort level in working closely with actuaries, accountants, and other analysts.
Understanding of basic actuarial concepts, e.
g.
, per member per month calculations.
Experience assembling complex financial forecasts and projections, based on differing underlying assumptions.
Ability to maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA).
General Requirements:
Excellent verbal and written communications skills, as well as excellent interpersonal skills to help maintain strong relationships and work with senior-level management.
Ability to work independently and be self-directed in completion of responsibilities.
Ability to work in a team environment.
Proven service orientation with attention to detail and follow-up.
Attendance according to Company standards.
Adheres to Company policies and procedures.
Ability to treat others with dignity, respect, and courtesy.
Ability to maintain patient, employee, and proprietary confidentiality.
Ability to communicate effectively in-person and in all forms of communication, strong presentation skills.
Ability to provide professional image and act professionally.
Ability to be flexible and adapt to changing situations.
We've Got You CoveredCGHC offers a comprehensive benefit package and broad range of programs to meet the needs of our employees to help protect your health, wealth, and future.
Recommended Skills Accounting Actuarial Science Analytical Assembly And Installation Attention To Detail Business Ethics Estimated Salary: $20 to $28 per hour based on qualifications.
As a cooperative, we are thousands of Wisconsin residents buying health insurance together, supported by a staff focused on providing the best possible service to our members.
We are a not-for-profit cooperative, governed by a Board of Directors made up of members who purchase our health insurance.
Any earnings are returned to our members in the form of lower prices and better services.
Our CultureWe are here because we can make a difference in the lives of others.
We believe that serving our community is meaningful work and we hold it in the highest regard.
We are vibrant, dynamic, and value-focused individuals who welcome different points of view, perspectives, and thoughtful solutions to challenges.
We encourage teamwork, integrity, mutual respect, honesty and doing the right thing.
We know the importance of showing appreciation for a job well done, celebrate our achievements, and make room for fun and laughter in the workplace.
Our JobWe are continuously improving our efforts to serve our members and lower their overall healthcare cost through our three key pillars:
Advocacy Partnership Innovation.
Does this sound like a culture you'd like to be a part of?Come join a fun team of committed professionals!How You'll Make a DifferenceThe Healthcare Data Analyst is responsible for performing sophisticated quantitative analyses for maintaining, and improving, the overall financial health and performance of the company.
These analyses will include risk-based capital forecasts; premium forecasting; financial performance by line of business, geographic area, and plan; budget forecasts; and claims analyses.
The claims-focused analyses will include those that focus on fraud, waste, and abuse; claims inventory; and analyses that identify improved utilization, or provider contracting, approaches.
The position will carry out analyses, and participate in decisions, regarding plan design, rate development, and creating financial models that will help the executive team to evaluate the ROI on new and different business propositions.
This position will report to the Director of Actuarial Services and will make significant contributions to the development and achievement of the company's strategic planning portfolio.
Strong collaboration with other departments within the company will be critical to the success of this position.
Utilize Your Skills By:
Combines data and information from multiple sources to analyze and draw conclusions about plan performance, including electronic health record, eligibility, or claims data.
Collects, analyzes, interprets, and presents comparative clinical and cost data, integrates benchmark information, and uses findings as a foundation for intervention and improvement.
Designs, develops, and continuously improves new and existing forecasting models and tools.
Creates and provides sound statistical analyses and frame business scenarios that are meaningful and have impact on critical business processes and/or decisions.
Conceptualizes and creates ad-hoc analyses, projects, and reports to assist in making appropriate business decisions and improvements.
Designs and enhances medical and pharmacy claim utilization, membership, and revenue reporting.
Analyzes key trends and performance related to clinical programs, provider network performance, other programs or practices, and providers of health care.
Develops new reports, tables, dashboards, and charts as needed, and assists with the maintenance of existing reports.
Supports, and enhances, both internal and external reporting around key financial metrics.
Collaborates with leaders across the plan to identify opportunities for improvement and best use of resources, anticipating business needs and proactively developing ideas and solutions to meet them.
Formulates data-based recommendations and effectively communicates them throughout the organization, providing explanations, information, and direction to business leaders regarding trends and forecasts.
Converts data-centered findings into recommended solutions, changes to business practices, and/or new opportunities.
Evaluates options and makes recommendations to business processes across the health plan to gain efficiencies and enhance performance.
Presents analytic trends and recommendations to all levels of the plan, including the ability to report findings to senior leadership.
Collaborates on written narrative summaries that outline analytical project purposes, methodologies employed, summary of findings, trends of interest, and opportunities for consideration.
Works on special projects as requested and all other duties as assigned.
What You'll Need to Bring:
Bachelor's Degree in statistics, mathematics, finance, accounting, or related field.
Experience working in a rapid cycle, decision support role, and very dynamic environment.
Advanced analytical skill set, including Excel skills is required, SQL programming is desired.
Ability to assist with, or support, risk adjustment systems and operations.
Experience integrating data sets from different sources and in different formats.
Ability to participate in strategic decision-making discussions.
Ability to handle multiple analysis projects simultaneously.
Ability to conceptualize, structure, perform, and interpret what if? Scenarios.
High comfort level in working closely with actuaries, accountants, and other analysts.
Understanding of basic actuarial concepts, e.
g.
, per member per month calculations.
Experience assembling complex financial forecasts and projections, based on differing underlying assumptions.
Ability to maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA).
General Requirements:
Excellent verbal and written communications skills, as well as excellent interpersonal skills to help maintain strong relationships and work with senior-level management.
Ability to work independently and be self-directed in completion of responsibilities.
Ability to work in a team environment.
Proven service orientation with attention to detail and follow-up.
Attendance according to Company standards.
Adheres to Company policies and procedures.
Ability to treat others with dignity, respect, and courtesy.
Ability to maintain patient, employee, and proprietary confidentiality.
Ability to communicate effectively in-person and in all forms of communication, strong presentation skills.
Ability to provide professional image and act professionally.
Ability to be flexible and adapt to changing situations.
We've Got You CoveredCGHC offers a comprehensive benefit package and broad range of programs to meet the needs of our employees to help protect your health, wealth, and future.
Recommended Skills Accounting Actuarial Science Analytical Assembly And Installation Attention To Detail Business Ethics Estimated Salary: $20 to $28 per hour based on qualifications.
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