- Bachelor's degree
- 3+ years of performance reporting experience
- Proficiency with SQL
- 3+ years of operational experience
- Strong analytical and data modeling skills
- Strong communication skills, both oral and written
- Strong knowledge of Microsoft Office 360 products (Excel, PowerPoint, Teams, SharePoint, PBI)
- Clinical experience
- Knowledge and experience in health care environment/managed care
- Power BI development experience
- Medicare Risk Adjustment knowledge
- Must be passionate about contributing to an organization focused on continuously improving consumer experiences, health outcomes, and program performance
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Business Analyst - Louisville, United States - Hire Talent
Description
In-home Health and Well-being Assessment (IHWA) is a program within client's Medicare Risk Adjustment under the Clinical, Quality, and Enterprise Solutions organization that delivers ~1M face to face member visits per year.
We contract with 2 primary vendors to send clinicians to spend 45-60 minutes with the member to review their medications, document the member's conditions, conduct screenings, educate the member and answer their questions, observe the member and their home environment, connect the member back to their PCP, and refer members to Client Clinical resources to address unmanaged conditions or SDOH needs.
The team is currently building robust tools and datasets that is allowing us track performance, identify opportunities, and to push back on unrealistic vendor projections.
The program has a lot of opportunity to build more leading indicator reporting for completions, improve performance projections, identify opportunities to increase IHWA visits, and improve bid goal setting.
The In-Home Assessment Senior Program Performance Analyst will be tasked with designing, drafting, and using reporting to identify gaps in performance, predict performance using leading indicators, create transparency to push back on vendor projections and confidence, and provide input to set annual bid goals with the vendors.
Some key KPIs are IHWA visit volumes and completion rates at the program, vendor, & state levels.Major partners for collaboration on issues, opportunities, and solutions are IHWA Director, leaders, SMEs, Vendor Managers and Vendors, MRA Finance, Prospective Programs Analytics, and HTA Analytics.
The In-Home Assessment Senior Program Performance Analyst will need to be proficient in SQL and Excel to quickly analyze data and to design ongoing reporting in Power BI with support of Business Intelligence reporting teams.
Experience with operational reporting is needed to identify leading indicators (scheduled visits, cancellation rates, clinician staffing, et al) to project performance ourselves and compare to vendor projections.
The In-Home Assessment Senior Program Performance Analyst will exercise some independent judgment and decision making on moderately complex issues and will work under minimal supervision, while delivering actionable transparency for Vendor Managers to push on vendors and helping to form accurate expectations for the markets and executive leadership.
A major deliverable will be ongoing monthly management of the business rules in a home-grown rules engine that delivers the right eligible membership to the vendors.
An in-depth knowledge of the business and market operations is key to this ongoing item.Required Qualifications
ll qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender, identity, national origin, disability, or protected veteran status.
