MCS Puerto Rico
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Senior Business Analyst
role at
MCS Puerto Rico 1 week ago Be among the first 25 applicants GENERAL DESCRIPTION:
Develops and analyzes multiple data reports and records related to business operations to present patterns and/or trends that allow management to develop strategies and improve existing processes. Offers management recommendations based on execution metrics for continuous improvement and informed decision-making. ESSENTIAL FUNCTIONS: Analyzes patterns and trends in data transactions that impact quality programs such as Healthcare Effectiveness Data and Information Set (HEDIS), Model of Care (MOC), and population profiles. Conducts interviews, reviews documents and processes to explain patterns, identifies potential data errors or trends, determines potential risks, and recommends corrections, referring them to departments for prompt issue resolution. Generates reports and records data using SQL tools, MS Access, Excel, and Power Pivot, integrating multiple databases. This involves managing complex table relationships with advanced criteria, which may include algorithms. Designs data experiments to test assumptions and hypotheses. Analyzes information from various database sources with a high level of detail and interprets and explains the data, presenting the requested information clearly and understandably. Develops, manages, and maintains ad-hoc reports using pre-existing criteria and their own criteria based on behavior or trend patterns and/or new specifications, as requested. Develops tools and processes to download, analyze, and store data in new and/or existing data structures and systems. Stays updated on changes in technical specifications and statistical algorithms by the Centers for Medicare & Medicaid Services (CMS) for the Stars Rating Program, monitoring and analyzing the impacts of proposed methodology changes. Participates regularly in meetings with specific stakeholders to offer recommendations based on previous analysis of measured performance as well as ongoing initiatives. Extracts and analyzes data from internal and external databases to optimize corporate strategies. Shares the report\'s results with various company divisions so they can decide how to take preventative action. Participates in developing the department and/or unit’s guidelines, policies, and processes. Provides technical support to other units and/or departments concerning producing reports and data analytics or metrics, as required. Must comply fully and consistently with all company policies and procedures, with local and federal laws as well as with the regulations applicable to our Industry, to maintain appropriate business and employment practices. May carry out other duties and responsibilities as assigned, according to the requirements of education and experience contained in this document. MINIMUM QUALIFICATIONS: Education and Experience:
Bachelor's degree in Information Systems, Computer Science, Business Administration, Statistics, Biostatistics, or Quantitative Methods. At least four (4) years of experience in database analytics and management, and preparing utilization analysis and reports, preferably within the health insurance industry. “Proven experience may be replaced by previously established requirements.” Certifications / Licenses:
N/A Other:
Knowledge and proficiency in Excel and at least two of the following database tools: ACCESS, Brio, Power Pivot, SQL, Advanced Excel, Crystal, and/or Cognos. Languages: Spanish –
Intermediate (comprehensive, writing and verbal) English –
Intermediate (comprehensive, writing and verbal) “Somos un patrono con igualdad de oportunidad en el empleo y tomamos Acción Afirmativa para reclutar a Mujeres, Minorías, Veteranos Protegidos y Personas con Impedimento” Seniority level Mid-Senior level Employment type Full-time Job function Research, Analyst, and Information Technology Industries: Insurance Referrals increase your chances of interviewing at MCS Puerto Rico by 2x Note:
This description excludes unrelated boilerplate and promotional fragments to improve clarity and adherence to formatting standards.
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Senior Business Analyst
role at
MCS Puerto Rico 1 week ago Be among the first 25 applicants GENERAL DESCRIPTION:
Develops and analyzes multiple data reports and records related to business operations to present patterns and/or trends that allow management to develop strategies and improve existing processes. Offers management recommendations based on execution metrics for continuous improvement and informed decision-making. ESSENTIAL FUNCTIONS: Analyzes patterns and trends in data transactions that impact quality programs such as Healthcare Effectiveness Data and Information Set (HEDIS), Model of Care (MOC), and population profiles. Conducts interviews, reviews documents and processes to explain patterns, identifies potential data errors or trends, determines potential risks, and recommends corrections, referring them to departments for prompt issue resolution. Generates reports and records data using SQL tools, MS Access, Excel, and Power Pivot, integrating multiple databases. This involves managing complex table relationships with advanced criteria, which may include algorithms. Designs data experiments to test assumptions and hypotheses. Analyzes information from various database sources with a high level of detail and interprets and explains the data, presenting the requested information clearly and understandably. Develops, manages, and maintains ad-hoc reports using pre-existing criteria and their own criteria based on behavior or trend patterns and/or new specifications, as requested. Develops tools and processes to download, analyze, and store data in new and/or existing data structures and systems. Stays updated on changes in technical specifications and statistical algorithms by the Centers for Medicare & Medicaid Services (CMS) for the Stars Rating Program, monitoring and analyzing the impacts of proposed methodology changes. Participates regularly in meetings with specific stakeholders to offer recommendations based on previous analysis of measured performance as well as ongoing initiatives. Extracts and analyzes data from internal and external databases to optimize corporate strategies. Shares the report\'s results with various company divisions so they can decide how to take preventative action. Participates in developing the department and/or unit’s guidelines, policies, and processes. Provides technical support to other units and/or departments concerning producing reports and data analytics or metrics, as required. Must comply fully and consistently with all company policies and procedures, with local and federal laws as well as with the regulations applicable to our Industry, to maintain appropriate business and employment practices. May carry out other duties and responsibilities as assigned, according to the requirements of education and experience contained in this document. MINIMUM QUALIFICATIONS: Education and Experience:
Bachelor's degree in Information Systems, Computer Science, Business Administration, Statistics, Biostatistics, or Quantitative Methods. At least four (4) years of experience in database analytics and management, and preparing utilization analysis and reports, preferably within the health insurance industry. “Proven experience may be replaced by previously established requirements.” Certifications / Licenses:
N/A Other:
Knowledge and proficiency in Excel and at least two of the following database tools: ACCESS, Brio, Power Pivot, SQL, Advanced Excel, Crystal, and/or Cognos. Languages: Spanish –
Intermediate (comprehensive, writing and verbal) English –
Intermediate (comprehensive, writing and verbal) “Somos un patrono con igualdad de oportunidad en el empleo y tomamos Acción Afirmativa para reclutar a Mujeres, Minorías, Veteranos Protegidos y Personas con Impedimento” Seniority level Mid-Senior level Employment type Full-time Job function Research, Analyst, and Information Technology Industries: Insurance Referrals increase your chances of interviewing at MCS Puerto Rico by 2x Note:
This description excludes unrelated boilerplate and promotional fragments to improve clarity and adherence to formatting standards.
#J-18808-Ljbffr