Business Analytics Advisor (Provider Contract & Network Underwriting - Liberty Valley Market) - Hybr

Summary

We are seeking a highly motivated and innovative team member to join our growing and dynamic Global Data & Analytics team as a Provider Contract & Network Underwriting Advisor.

In this role, you will conducts hospital and professional provider contract underwriting/analysis, partnering with Contracting to deliver unit cost results in line with trend/cost expectations to ensure competitive positioning within the marketplace assist contractors in creating network solutions and provider contracts to ensure our competitive position in the market.

You will use financial models to evaluate the impact of proposed terms on profitability, trend and other metrics.

You will also partner with network management, medical management, and sales units to understand resulting medical expense results and improve future negotiation strategy.

Responsibilities


* Analyze impact to trends for facility contract negotiations


* Effectively influence contracting in a strategic fashion and offer meaningful options during negotiations with a provider


* Provide ad hoc analysis and deep dives into data as appropriate to support negotiation and provide value to our contracting partners


* Summarize and explain findings and recommendations


* Independently and effectively manage the planning process for assigned markets and drive the plan to meet overall corporate planning objectives


* Proactively identify opportunities for trend reduction and engage contracting to build these into plan where appropriate


* Keep management informed as to the progress of Plan and proactively identify risk and opportunities for meeting the plan results

Qualifications


* 5+ years' of experience in health care/managed care work experience


* Strong Experience with various data mining and reporting tools, such as Microsoft Excel skills Microsoft Access, or SAS/SQL language


* Experience in TMC and/or Contract Underwriting preferred


* Experience working with claim data and familiarity with standard medical coding: CPT, ICD9, HCPC preferred


* Understanding of managed care business processes, data, systems, and applications for claims payment, enrollment, benefit design, and utilization management


* Strong analytical and problem solving skills


* Strong communication skills to include written, oral and group presentation


* Ability to work independently while managing multiple tasks and meeting deadlines

If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

For this position, we anticipate offering an annual salary of 96,000 - 160,000 USD / yearly, depending on relevant factors, including experience and geographic location.

This role is also anticipated to be eligible to participate in an annual bonus plan.

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