The Managed Health Care Analyst will provide consultation and analyses to client partners and internal stakeholders in support of benefit initiatives and programs in the areas of medical cost and utilization management, sales and marketing, quality improvement and wellness. This position acts as a consultant to external customers and internal program managers to improve the design and evaluation of health plan benefits and programs; completes analyses to guide decisions; makes recommendations on program direction; and supports client initiatives through the development of reports and analyses based on multiple sources of data. Additional responsibilities include developing and monitoring models to assess program impact and value; researching and developing benchmarks; analyzing trends; and the advancement of the Plan’s data systems in alignment with future program needs. The Managed Health Care Analyst will develop and deliver presentations as a participant in external meetings to advance the Plan’s strategic objectives.
Client Focused Position Qualifications:
A four-year college degree in health care, business, statistics, math or a closely related field required; advanced study desirable.
Three to five years of managed care and health insurance experience, including experience in reimbursement methodologies, data research and reporting required.
Microsoft Excel and SAS programming knowledge required.
Clinical Focused Position Qualifications:
All of the above, including clinical knowledge and experience.
Degree in business, health care or related field.
Three to five years experience in health care administration or insurance.