Job Description

Responsible for serving as an expert in data analysis, reporting and formulating recommendations and providing guidance to other data analysts. Active participation in solutioning and design on basis of quality parameters at every step and raise risk flags at the early stage and identify the mitigation plan. Primary duties may include, but are not limited to: Creates and maintains databases to track business performance. Analyzes data and summarizes performance using summary statistical procedures. Develops and analyzes business performance reports (e.g. for claims data, provider data, utilization data) and provides notations of performance deviations and anomalies. Creates and publishes periodic reports, as well as any necessary ad hoc reports. May require taking business issue and devising best way to develop appropriate diagnostic and/or tracking data that will translate business requirements into usable decision support tools. May make recommendations based upon data analysis. Provides analytic consultation to other business areas, leadership or external customers. Data analysis and reporting encompasses a much higher level of complexity. Designated & dedicated to a market, responsible for State deliverables, data and trend analysis, and working with Health Plans and Health Care Networks individual needs, including alignment to Provider Resolution leads to root cause/ remediate escalations . May partner with Healthcare Networks at a relationship level via Jira intake submissions and execution of requests. Managing Risks and Issues Excellent communication skills for upstream and downstream teams with critical information Strong Stakeholder management and negotiating abilities with experience in dealing with senior management Generating and compiling reports based on the findings, complete with probable causes and possible solutions This individual will apply proven communication, analytical, and problem-solving skills to help maximize the benefit Mentor and train an experienced and competent staff across teams Drive & Deliver a structured governing project management processes for the team. Mentor and coach team towards collective goals Functional Knowledge in Health care domain QUALIFICATION Requires BA/BS degree; broad based experience to plan and design low to medium complex project portfolios; or any combination of education and experience, which would provide an equivalent background. EXPERIENCE 10+ years experience in US Healthcare; and 2+ yrs of any combination of education and experience which would provide an equivalent technical background. Hands on experience on upstream/ Middleware/downstream applications for Claims, Providers Hands-on experience on various software models Waterfall, Agile-Scrum, JIRA Experience with Healthcare Provider preferred SKILLS AND COMPETENCIES Experience of query tools and statistical software is strongly preferred Ability to collaborate with variety of cross-functional team members Competent in problem solving, team building, planning and decision making