Senior Data Analyst - Healthcare Analytics

We are seeking a strong Data Analyst in the healthcare space for our client in the St. Louis, MO area. This is a fully remote job

US Citizens or Green Card Holders ONLY!!

No C2C

No Third Party Agencies

Fully remote, ideally Central or Eastern Time Zone candidates. Must be US Citizen or Green Card holder

Must-haves

• Bachelor’s degree in business, economics, statistics, mathematics, actuarial science, public health, health informatics, healthcare administration, finance or related field or equivalent experience. Master's degree preferred. 4+ years of experience working with large databases, data verification, and data management or 2+ years of IT experience.

Required Skills

• Experience with Medicare, Medicaid and Marketplace analytics Strong understanding of payment and reimbursement methodologies, including DRG pricing, APC, and EAPG payment methodologies Strong SQL skills, including the ability to write and understand complex queries, SELECT statements, and multiple types of JOINs Advanced Excel skills, including: Pivot Tables Power Query VLOOKUP / XLOOKUP Averages, aggregations, formatting Creating and nesting formulas to build metrics and perform financial modeling Power BI experience, with familiarity in DAX and Power Pivot. Experience with financial analytics tools and basic financial modeling/sizing Collaborate with cross-functional teams to evaluate QAI (Quality and Affordability Initiatives), MLR (Medical Loss Ratio) targets, and related key performance indicators (KPIs)

Previous Answer

• Experience with Medicare, Medicaid and Marketplace analytics Strong SQL skills, including the ability to write and understand complex queries, SELECT statements, and multiple types of JOINs. Advanced Excel skills, including: Pivot Tables Power Query VLOOKUP / XLOOKUP Averages, aggregations, formatting Creating and nesting formulas to build metrics and perform financial modeling Power BI experience, with familiarity in DAX and Power Pivot. Experience with financial analytics tools and basic financial modeling/sizing Strong understanding of payment methodologies, including DRG pricing, APC, and EAPG payment methodologies

Preferred or Nice-to-have Skills

• Python and R

Previous Answer

• Python and R Collaborate with cross-functional teams to evaluate QAI (Quality and Affordability Initiatives), MLR (Medical Loss Ratio) targets, and related key performance indicators (KPIs)

Industry Experience: Managed Care Analytics - payment and reimbursement methodologies - Medical Economics (Healthcare), Actuarial/Financial experience in a healthcare setting

Previous Answer: Managed Care Analytics - payment methodologies - Medical Economics (Healthcare)

What else would you like us to know that we haven't asked? This is a very specific type of candidate this hiring group is looking for - we are expanding our Medical Economics team and have had success with folks who have some actuarial experience as well - we have also had success with some consultants who have worked in managed care in the medical economics space

Job description

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.

Position Purpose: Analyze integrated and extensive datasets to extract value, which directly impacts and influences business decisions. Work collaboratively with key business stakeholders to identify areas of value, develop solutions, and deliver insights to reduce overall cost of care for members and improve their clinical outcomes.

• Interpret and analyze data from multiple sources including claims, provider, member, and encounters data. Identify and assess the business impact of trends
• Develop, maintain, and troubleshoot complex scripts and reports developed using SQL, Microsoft Excel, or other analytics tools
• Contribute to the planning and execution of large-scale projects with limited direction from leadership
• Assist in the design, testing, and implementation of process enhancements and identify opportunities for automation
• Identify and perform root-cause analysis of data irregularities and present findings and proposed solutions to leadership and/or customers
• Manage multiple, variable tasks and data review processes with limited supervision within targeted timelines and thrive in a demanding, quickly changing environment
• Demonstrate a sense of ownership over projects and ask probing questions to understand the business value of tasks
• Apply expertise in quantitative analysis, data mining, and the presentation of data to see beyond the numbers and understand how customers interact with analytic products
• Partner cross-functionally at all levels of the organization and effectively, both verbally and visually, communicate findings and insights to non-technical business partners
• Independently engage with customers and business partners to gather requirements and validate results
• Communicate and present data-driven insights and recommendations to both internal and external stakeholders, soliciting and incorporating feedback when required
• Provide technical guidance to junior analysts

E

ducation/Experience: Bachelor’s degree in business, economics, statistics, mathematics, actuarial science, public health, health informatics, healthcare administration, finance or related field or equivalent experience. Master's degree preferred. 4+ years of experience working with large databases, data verification, and data management or 2+ years of IT experience. Healthcare analytics experience preferred. Working knowledge of SQL/querying languages. Preferred knowledge of programmatic coding languages such as Python and R. Knowledge of statistical, analytical, or data mining techniques including basic data modeling, trend analysis, and root-cause analysis preferred. Preferred knowledge of modern business intelligence and visualization tools including Microsoft PowerBI. Experience in emerging trend analysis, financial modeling, claims pricing, contract/network analysis, and/or ROI evaluation preferred. Familiarity with claims payment, utilization management, provider/vendor contracts, risk adjustment for government sponsored healthcare desired.