- Obtain, verify, analyze, and model financial target outcomes such as return-on-investment (ROI) and payback periods using claims and authorization data.
- Lead and/or actively participate in new solution strategy sessions with Carelon MBM/PAS medical directors and Solution Design consultants.
- Partner with Actuarial team members to validate cost model outcomes, savings modeling assumptions, and ROI recommendations.
- Identify medical cost, service utilization, service intensity, unit cost, and membership trends to identify new opportunities for product expansion.
- Understand cost levers of Carelon MBM/PAS services and make recommendations on program design.
- Accountable for developing a measurement system to assess financial performance of new solutions following implementation.
- Ensure that cost and saving model assumptions are tracking with actual solution performance.
- Structure and perform independent analyses and package findings for executive level stakeholders.
- Conduct exploratory research on medical finance and cost-of-care outcomes by publishing key cost trends and benchmarks.
- 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.
- 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.
- Establish actuarially-sound cost modeling and forecasting methodologies that accurately assess future business performance across new go-to-market solutions and capabilities.
- Use SQL, Excel, PowerPoint, and other tools to transform data into insights and report findings to internal and external business partners.
- Requires a BS/BA degree in related field and a minimum of 3 years data analysis or related experience; or any combination of education and experience which would provide an equivalent background.
- Advanced SQL and Excel skills strongly preferred.
- Intellectual curiosity, superior data mining skills, and the ability to distill financial impacts and levers and communicate them to non-technical audiences.
- Previous experience solving complex, medical cost-related problems using large healthcare data sets.
- Proven ability to empower analytics-driven business decisions, experience applying statistical concepts, data visualization skills, knowledge of medical claims data, and/or actuarial experience.
- Familiarity with medical management or population health programs is highly desired.
- Possess working knowledge of healthcare data and measurement standards such as ICD10, CPT/HCPCS, MS-DRG, DxCG, PMPM, and utilization per 1,000.
- Snowflake, R or Python a plus.
- Base statistical skills to analyze, display, describe and summarize data into actionable insights.
- Data visualization experience in QlikSense, Business Objects, Tableau, or other BI tools is a plus.
- Excellent organizational, analysis planning, and communication skills is critical.
- Ability to participate collaboratively on teams producing complex analyses.
- Healthcare Analytics consulting experience highly desired.
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Data Analytics/Data Science Analyst - St. Louis, United States - Elevance Health
Description
Job Description
:Data Analytics/Data Science Analyst
Location: This position will work a hybrid model (remote and office). An ideal candidate must live within 50 miles of one of our Elevance Health PulsePoint locations listed here: Chicago, IL; Indianapolis, IN; St. Louis, MO.
At Carelon Medical Benefits Management/Post Acute Services (MBM/PAS) , a proud member of the Elevance Health, Inc. family of companies, it's a powerful combination, and the foundation upon which we're creating greater access to care for our members, greater value for our customers, and greater health for our communities.
The Data Analytics/Data Science Analyst is responsible for analyzing, reporting and developing recommendations on data related to complex and varied business metrics. Typically provides technical assistance to lower level staff.
How you will make an impact:
Minimum Qualifications:
Highly Preferred Skills, Experiences and Competencies:
Preferred Skills, Experiences and Competencies:
Job Level:
Non-Management ExemptWorkshift:
1st Shift (United States of America)Job Family:
RDA > Business/Health InfoPlease be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact for assistance.
