Sr Health Plan Ops Analyst Job Listing at MedStar Medical Group in Baltimore, MD (Job ID req41768)

Description

General Summary of Position
Defines, develops, and prepares reports, dashboards, and analysis to support organization's goal of providing executive leadership with actionable intelligence related to the financial, clinical, and analytical performance. Provides specialized analytics and data driven insights to assist in developing recommendations for process improvement, identifying trends, and identifying root cause analysis. Collaborates with various areas to operationalize process improvements and mitigates/resolves negative trends in operational and clinical data. This position requires a thorough understanding of departmental and clinical operations, data modeling, and programmatic methodologies.

Primary Duties and Responsibilities

Minimum Qualifications
Education

• Bachelor's degree in Healthcare Administration, Finance, Information Technology, Business Adminsitration or related field required

Experience

• 5-7 years Experience in managed care or healthcare, accounting, finance, analytics, project leadership or related experience. required
• 5-7 years Experience in relational database management and analysis, experience in Excel, ODBC, SQL, SSRS and SISS reporting, Tableau reporting and care management systems required

Licenses and Certifications

• Certified Tableau Specialist Tableau certification required
• SQL certification required

Knowledge, Skills, and Abilities

• An in-depth understanding of national reimbursement mechanisms (CMS-1500, UB forms, ICD-10, PPS, CPT, HCPCS) as well as local regulatory environment.
• Strong understanding of operational activities around claims, enrollment, call center, utilization management, etc. related data.
• Extensive database experience (SQL coding experience preferred) with ability to access and manipulate significant amounts of complex data to produce meaningful and useful reports for senior management.
• Experience in advanced statistical models, business intelligence tools, risk adjustment methodologies, and data visualization software strongly preferred.
• Tableau experience is preferred but not required.
• Ability to convey verbal and written information effectively.
• Ability to follow verbal and written instructions.
• Verbal and written communication skills.
• Computer skills preferred.

This position has a hiring range of $33.86 - $63.13