Senior Healthcare Analyst
The Senior Healthcare Analyst directly impacts organizational change by providing data, information and analysis that drive and inform specific projects and strategic initiatives. The person in this position is instrumental in building accurate and timely analytic modeling and documenting processes. This person is responsible for analyzing a variety of health plan data and leads financial and actuarial projects. Key outputs include the aggregation of large datasets, creating accurate and timely financial reports, performing financial calculations, and submitting actuarial analyses and regulatory filings.
ESSENTIAL DUTIES AND RESPONSIBILITIES
- To perform this job successfully, an individual must be able to perform each essential duty listed satisfactorily.
- Responsible for analytic activities (data collection, modeling, analysis, reporting, & documentation), including, but not limited to, revenues, medical expenses and utilization, capitation, risk score trend monitoring, medical loss ratios, ROI, and contract negotiations.
- Coordinates the gathering of all necessary information sources and works closely with our consulting actuaries in support of the Medicare bids, annual rate-setting, risk score impact, and large group underwriting process.
- Analyzes data to generate dashboard metrics and reports at required intervals (e.g., monthly/quarterly) for senior management, including medical loss ratios, medical costs, medical trends, and provider profiles.
- Monitors regulatory changes and their financial impacts to CCHP.
- Potentially supervises staff member(s).
- Perform other related duties as required or assigned.
- Bachelors’ degree or equivalent in Business Administration, Health Care or related field required.
- Masters’ degree or equivalent in Business Administration, Health Care or related field preferred
- Three years’ demonstrated experience in market analysis and financial analysis in a health plan setting preferred.
- Must be able to explain health care financing and its relation to third party provider contractual arrangements.
- Strong interpersonal and communication skills and ability to work effectively with a wide range of constituencies, particularly senior management; ability to develop and deliver presentations.
- Excellent time management, organizing and coordinating skills.
- Strong history of achieving personal and corporate goals and objectives.
- Must demonstrate professionalism, good judgment, and tact when dealing with sensitive and confidential issues.
- Strong skills in Microsoft applications including MS Office; graphic software experience preferred.
- Familiar with Medicare and Covered CA bid processes.
In our efforts to control the spread of COVID-19 and its variants, CCHP requires that its employees be fully vaccinated as of their start date. If you require a medical or religious accommodation we will engage in the interactive process with you. Proof of vaccination will be required prior to start. If we make you an offer and you are not yet vaccinated, we will accommodate a delay in start date. CCHP may also mandate that its employees receive vaccine boosters, and all accommodation laws will be followed.