Sr. Healthcare Data Analyst - Alpharetta, United States - Southeast Primary Care Partners

Description

Job Type Full-timeDescription(Local Atlanta, GA - Hybrid)The Value-Based Care Data Analyst at SPCP plays a pivotal role in enhancing healthcare quality and cost efficiency.

This position involves extensive data collection and analysis from multiple sources to support regulatory reporting, clinical performance improvement, and operational objectives.

The analyst will identify opportunities for better patient outcomes and enhanced performance in value-based care programs, focusing on financial data and applying statistical or financial models to aid organizational goals.

Key responsibilities include managing critical reporting and analysis tasks related to customer service, enrollment, and eligibility. The role demands proficiency in database query design, development, maintenance, and enhancement, ensuring data accuracy and relevance.

As a data analysis expert, the analyst's insights are crucial for strategic decision-making, influencing SEMG's management with actionable findings and recommendations.

A significant part of the role involves focusing on Medicare Risk Adjustment, conducting business analyses, streamlining workflows, and leading user acceptance testing, thereby playing an essential part in guiding strategic decisions and process improvements at SEMG.

RequirementsReporting directly to the VP, Population Health, the analyst will work with clinical leaders and other team members to:
Develop, refine, and maintain clinical performance reports and dashboards using our population health data warehouse and analytics platform.

Work with health plans and other 3rd parties to collect and integrate relevant clinical and claims data into our warehouse.

Identify and develop data reporting strategies to support clinical initiativesCollaborate with Director, Population Health to collect and submit required data to health plans and CMS to meet program and regulatory reporting requirements.

Actively participate in performance review sessions with senior leadership and/or health plans, including developing content as needed. Researches, retrieves, designs and delivers organized analytics and reporting of medical claimsAnalyzes benchmarking data, reports, processes, and measurements.


Report Development:
Design, test, document, and maintain database queries and reports

Reporting Procedures:
Develop systematic processes for regular and on-demand reporting

Data Interpretation:
Transform complex data into clear, comprehensible formats for diverse stakeholders

Data Integration and Analysis:
Merge multiple data sources to understand customer behavior for service enhancement

Project Analysis Management:
Oversee reporting and analytical aspects of business initiative projects

Reporting Innovation:
Innovate and implement methods to improve report quality and depth

System Issue Resolution:
Address and resolve Customer Service system issues

Online Tool Development:
Create digital tools to enhance customer service efficiency and effectiveness

Risk Adjustment:
Perform business analysis, serve as a liaison among teams, update workflows, and manage user acceptance testing.
Forecasts cost and utilization trends and creates financial modeling using claims and other health care data.
Develops and documents complex business, analysis and reporting requirements.
Evaluates and prioritizes data changes and enhancements.
Reviews the analytics and reporting of others within the department.
Makes decisions of considerable impact and consequences involving healthcare expense trends.
Interprets data, facts and/or trends independently and makes business recommendations to management.
Coordinates a variety of projects/requests simultaneously and ensures timely completion in accordance with business initiatives.
Develops innovative approaches to achieve deliverables.
Serves as the subject matter expert on healthcare trends/models by other departments in the organization.

Serve as a leader/mentor to the analysts in the department as well as reviews their work as deemed necessary by business needs.

Performs all other related duties as assigned.

Essential Job FunctionsMinimum Required Education, Experience & SkillsBachelor's degree in Business, Accounting, Finance, Economics, Mathematics, Healthcare Administration or Statistics (4 additional years of comparable work experience beyond the required years of experience may be substituted in lieu of a bachelor's degree).Minimum three years demonstrated experience in evaluating and improving clinical data collection and maintaining clinical quality databases and systems.

Ability to interact effectively with different business departments, team members, and external clients at all levelsAdvanced experience with PowerPoint, Power BI, and Electronic Health Records Microsoft Excel, Access, including intermediate knowledge of SQL.Excellent critical thinking and problem solving skills.

Ability to work independently, coordinate multiple projects simultaneously, and meet required deadlines.
Demonstrated knowledge of healthcare data elements.
Proficiency in data analysis and statistical/financial modeling.
Strong ability in database query design and report generation.
Experience in regulatory reporting and performance improvement in healthcare.
Knowledge of Medicare Risk Adjustment and related business processes.
Ability to influence decision-making through insightful data analysis.

Preferred Education, Experience & SkillsAbility to deal with ambiguity and drive resultsDesire to make an impact, manage multiple tasks, and shift priorities quicklySolid interpersonal skills and the ability to influence othersStrong communication skills, written and verbalLeadership skills and results orientedPhysical & Mental Requirements:
(check all that apply)1 Ability to lift up to 10 pounds0 Ability to push or pull heavy objects using up to 25 pounds of force1 Ability to sit for extended periods of time1 Ability to stand for extended periods of time1 Ability to use fine motor skills to operate office equipment and/or machinery0 Ability to properly drive and operate a company vehicle1 Ability to receive and comprehend instructions verbally and/or in writing1 Ability to use logical reasoning for simple and complex problem solving