Offer summary

Qualifications:

Bachelor's degree in Mathematics, Statistics, Finance, Actuarial Science, Data Science, or related field., 5-7 years of experience in healthcare analytics, preferably in a managed care setting., Proficiency in SQL and Microsoft SQL Server Suite of Products (SSMS) and MS Excel required., Excellent oral and written communication skills with the ability to explain technical concepts to a non-technical audience..

Key responsibilities:

Monitor Utilization Management and Case Management activities by developing key performance metrics and benchmarks.

Conduct prospective savings analyses to support Population Health program initiatives.

Develop statistical models and algorithms for identifying high-risk members and measure program performance.

Build and maintain client-facing reports, dashboards, and lead program performance review presentations.

Job description

About The Role
The Senior Data Analyst, Population Health will be an analytically driven team player, responsible for understanding business needs and objectives, eliciting requirements from stakeholders, and analyzing data and processes to identify opportunities for improvement. This role will support BHPS Population Health Management, Utilization Management and Complex Case Management. As Senior Data Analyst, Population Health, you will be challenged to think creatively while developing actionable insights to inform client and program strategy.

Primary Responsibilities

Monitor Utilization Management and Case Management activities through the identification and development of key performance metrics and benchmarks
Conduct prospective savings analyses in support of Population Health program initiatives
Develop statistical models that deliver meaningful insights on cost, utilization and clinical outcomes based on various data sources, including claims and authorizations
Develop algorithms for identifying high-risk members, and measure the performance of Disease Management and other Medical Management programs
Develop reporting on NCQA HEDIS and other quality measures
Build and maintain client-facing reports, dashboards, and analyses
Lead program performance review presentations with clinical program managers, client account managers, and external clients, as needed
Collaborate with Medical Management to provide ongoing support
Manage internal and external client requests and timelines to ensure timely delivery
Provide ad hoc analytical support as necessary

Essential Qualifications

Bachelors' degree required, preferably in Mathematics, Statistics, Finance, Actuarial Science, Data Science, or related field.
5-7 years of experience in healthcare analytics, preferably in a managed care setting.
Proficiency in SQL and Microsoft SQL Server Suite of Products (SSMS) required.
Proficiency in MS Excel required.
Experience with clinical outcomes reporting and cost and utilization analysis.
Experience with developing client-facing reports.
Ability to explain technical concepts to a non-technical audience.
Ability to effectively manage and prioritize several concurrent projects.
Excellent oral and written communications skills.
Experience with Business Intelligence applications and DAX functions (PowerPivot, Power BI, Tableau) a plus.
Experience with Predictive Analytics a plus.

About
At Brighton Health Plan Solutions, LLC, our people are committed to the improvement of how healthcare is accessed and delivered. When you join our team, you’ll become part of a diverse and welcoming culture focused on encouragement, respect and increasing diversity, inclusion, and a sense of belonging at every level. Here, you’ll be encouraged to bring your authentic self to work with all your unique abilities.
Brighton Health Plan Solutions partners with self-insured employers, Taft-Hartley Trusts, health systems, providers as well as other TPAs, and enables them to solve the problems facing today’s healthcare with our flexible and cutting-edge third-party administration services. Our unique perspective stems from decades of health plan management expertise, our proprietary provider networks, and innovative technology platform. As a healthcare enablement company, we unlock opportunities that provide clients with the customizable tools they need to enhance the member experience, improve health outcomes, and achieve their healthcare goals and objectives. Together with our trusted partners, we are transforming the health plan experience with the promise of turning today’s challenges into tomorrow’s solutions.
Come be a part of the Brightest Ideas in Healthcare™.

Company Mission
Transform the health plan experience – how health care is accessed and delivered – by bringing outstanding products and services to our partners.

Company Vision
Redefine health care quality and value by aligning the incentives of our partners in powerful and unique ways.

DEI Purpose Statement
At BHPS, we encourage all team members to bring your authentic selves to work with all your unique abilities. We respect how you experience the world and welcome you to bring the fullness of your lived experience into the workplace. We are building, nurturing, and embracing a culture focused on increasing diversity, inclusion and a sense of belonging at every level.

*We are an Equal Opportunity Employer
*Open to fully remote candidates

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