SCAN
Sr Data Analyst - Value Based Healthcare Analytics
SCAN Group is a not-for-profit organization dedicated to tackling the most pressing issues facing older adults in the United States. SCAN Group is the sole corporate member of SCAN Health Plan, serving more than 277,000 members in CA, AZ, NV, TX and NM. SCAN has been a mission-driven organization for more than 45 years and is known as a leading expert in senior healthcare. Job Description The Job Support SCAN's value-based partnerships and care delivery efforts with medical groups, independent provider associations (IPAs), hospitals, and integrated delivery systems in this growing area. Leverage clinical and pharmacy claims, demographic, authorizations, and care management data to evaluate financial risk, identify medical economic trends, and assess the performance of clinical programs for quality and financial outcomes. Focus on medical economics, utilization management, care standards variation analysis, key performance indicators and executive reporting. Collaborate with value-based care leaders to contribute to strategy and expansion objectives. You Will Serve as subject matter expert (SME) for value-based care / shared risk utilization management analytics to support methodological and business case questions. Maintain, enhance, and build models, reports, and dashboards that connect insights to business impacts, and propose actionable strategies to partners and leaders through storytelling and data visualizations. Research, evaluate and deploy new tools, frameworks and patterns, including identifying gaps and opportunities for improvement of current care delivery businesses. Deliver performance reporting to partners and stakeholders, communicating findings and making recommendations for continuous improvement. Maintain knowledge of operations sufficient to identify factors that may affect reporting findings. In conjunction with payer strategy/network management, develop financial models to support optimization, negotiation and expansion of value-based care and shared risk arrangements. Lead and coordinate standard and ad hoc analytics projects through complex situations to completion under deadlines, including QA of team members’ work. Ensure continuous improvement in analytics deliverables and insights that break new ground. Develop and maintain technical specifications and end-user documentation for assigned projects and analyses. Gain a strong understanding of SCAN’s contracts with Medical Groups and model analyses to support contract negotiations. Interface with SCAN value-based care, medical management, direct care delivery, risk adjustment, finance, network management and other cross-functional areas. Build relationships across the data & analytics team; maintain professional knowledge through education and professional networks. Actively support SCAN’s vision and goals. Other duties as assigned. Your Qualifications Bachelor's Degree or equivalent experience preferred 3-5 years of experience in managed care analytics and/or healthcare data analysis Track record of successful engagement with partners and stakeholders in value-based healthcare models Direct experience with Medicare Advantage, Medical Economics, or utilization management analytics at a health plan Strong knowledge of payer-provider contracts is a plus Proficiency in SQL, Microsoft SSMS, R, Python, Alteryx, and dashboard tools such as Tableau or Power BI; Snowflake and/or Databricks experience preferred Advanced understanding of healthcare informatics and medical economics (ICD, CPT, Rev codes, PMPM, utilization rates, case mix, attribution methods, risk adjustment, metrics, and related tools) Excellent communication skills, both oral and written; ability to present to leadership; experience in a matrix environment preferred Technical expertise with advanced analytical skills Strong communication and interpersonal skills Problem solving skills What's in it for you? Base Pay Range: $92,400 to $159,133 annually Annual bonus program Wellness program Generous paid time off (PTO) 11 paid holidays per year, 1 floating holiday, birthday off, and 2 volunteer days Excellent 401(k) plan with employer match Employee recognition program Tuition reimbursement Opportunity to make a difference for our members and community SCAN is an Equal Employment Opportunity and Affirmative Action workplace. We are committed to creating a workforce that reflects our community through inclusive programs and initiatives such as equal pay, employee resource groups, and inclusive benefits. A background check is required. Equal Opportunity Employer/Protected Veterans/Individuals With Disabilities The contractor will not discriminate against employees or applicants who inquire about, discuss, or disclose their pay. However, employees who have access to compensation information as part of their essential job functions cannot disclose it to others who do not have access, unless allowed by law. 41 CFR 60-1.35(c).
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SCAN Group is a not-for-profit organization dedicated to tackling the most pressing issues facing older adults in the United States. SCAN Group is the sole corporate member of SCAN Health Plan, serving more than 277,000 members in CA, AZ, NV, TX and NM. SCAN has been a mission-driven organization for more than 45 years and is known as a leading expert in senior healthcare. Job Description The Job Support SCAN's value-based partnerships and care delivery efforts with medical groups, independent provider associations (IPAs), hospitals, and integrated delivery systems in this growing area. Leverage clinical and pharmacy claims, demographic, authorizations, and care management data to evaluate financial risk, identify medical economic trends, and assess the performance of clinical programs for quality and financial outcomes. Focus on medical economics, utilization management, care standards variation analysis, key performance indicators and executive reporting. Collaborate with value-based care leaders to contribute to strategy and expansion objectives. You Will Serve as subject matter expert (SME) for value-based care / shared risk utilization management analytics to support methodological and business case questions. Maintain, enhance, and build models, reports, and dashboards that connect insights to business impacts, and propose actionable strategies to partners and leaders through storytelling and data visualizations. Research, evaluate and deploy new tools, frameworks and patterns, including identifying gaps and opportunities for improvement of current care delivery businesses. Deliver performance reporting to partners and stakeholders, communicating findings and making recommendations for continuous improvement. Maintain knowledge of operations sufficient to identify factors that may affect reporting findings. In conjunction with payer strategy/network management, develop financial models to support optimization, negotiation and expansion of value-based care and shared risk arrangements. Lead and coordinate standard and ad hoc analytics projects through complex situations to completion under deadlines, including QA of team members’ work. Ensure continuous improvement in analytics deliverables and insights that break new ground. Develop and maintain technical specifications and end-user documentation for assigned projects and analyses. Gain a strong understanding of SCAN’s contracts with Medical Groups and model analyses to support contract negotiations. Interface with SCAN value-based care, medical management, direct care delivery, risk adjustment, finance, network management and other cross-functional areas. Build relationships across the data & analytics team; maintain professional knowledge through education and professional networks. Actively support SCAN’s vision and goals. Other duties as assigned. Your Qualifications Bachelor's Degree or equivalent experience preferred 3-5 years of experience in managed care analytics and/or healthcare data analysis Track record of successful engagement with partners and stakeholders in value-based healthcare models Direct experience with Medicare Advantage, Medical Economics, or utilization management analytics at a health plan Strong knowledge of payer-provider contracts is a plus Proficiency in SQL, Microsoft SSMS, R, Python, Alteryx, and dashboard tools such as Tableau or Power BI; Snowflake and/or Databricks experience preferred Advanced understanding of healthcare informatics and medical economics (ICD, CPT, Rev codes, PMPM, utilization rates, case mix, attribution methods, risk adjustment, metrics, and related tools) Excellent communication skills, both oral and written; ability to present to leadership; experience in a matrix environment preferred Technical expertise with advanced analytical skills Strong communication and interpersonal skills Problem solving skills What's in it for you? Base Pay Range: $92,400 to $159,133 annually Annual bonus program Wellness program Generous paid time off (PTO) 11 paid holidays per year, 1 floating holiday, birthday off, and 2 volunteer days Excellent 401(k) plan with employer match Employee recognition program Tuition reimbursement Opportunity to make a difference for our members and community SCAN is an Equal Employment Opportunity and Affirmative Action workplace. We are committed to creating a workforce that reflects our community through inclusive programs and initiatives such as equal pay, employee resource groups, and inclusive benefits. A background check is required. Equal Opportunity Employer/Protected Veterans/Individuals With Disabilities The contractor will not discriminate against employees or applicants who inquire about, discuss, or disclose their pay. However, employees who have access to compensation information as part of their essential job functions cannot disclose it to others who do not have access, unless allowed by law. 41 CFR 60-1.35(c).
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