Sr. Business Intelligence Engineer - Peak Health

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Come join Peak Health – a fast growing provider led health plan, as a Senior Business Intelligence Engineer (Operational Analytics). Your data management and analysis skills combined with your critical thinking will help us advance operational performance across Peak Health by transforming raw data into actionable intelligence that improves efficiency, throughput, quality, and member/provider experience.

The Senior Business Intelligence Engineer (Operational Analytics) will collaborate closely with the Operational Analytics leadership, as well as peers and colleagues, across product, operations, medical management, and provider contracting to support and implement high-quality, data-driven decisions. The ideal candidate has a knack for seeing solutions in data sets and the business mindset to convert insights into strategic opportunities. They will ensure data accuracy and consistent reporting by designing and creating optimal processes and procedures for analytics employees to follow. They will use advanced data modeling, predictive modeling, and analytical techniques to interpret key findings from company data and leverage these insights that will help us design, build, and manage our health plan.

MINIMUM QUALIFICATIONS:

EDUCATION, CERTIFICATION, AND/OR LICENSURE:

1. Bachelor’s Degree in Health Administration, Business Administration, Mathematics, Computer Science, Statistics, Information Systems, or a related field.

To be completed as established by department:

(Administered at Department level)

Epic Accreditation for Cogito, Caboodle Data Model, and Clarity Data Model or able to obtain within 60 days of hire.

EXPERIENCE:

1. Five (5) year of experience monitoring, managing, manipulating, and drawing insights from data in a managed care company.

2. Three (3) years of experience working with claims data to evaluate reimbursement changes, payment discrepancies, medical expense opportunities, quality outcomes and risk

PREFERRED QUALIFICATIONS:

EXPERIENCE:

1. Master’s Degree in Health Administration, Business Administration, Computer Science, Statistics, Information Systems, or a related field.

2. Three (3) years of experience working with Medicare and/or Medicaid Data.

3. Familiarity with health plan operations, data architecture, and Medicare/Medicare regulatory environments.

CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position. They are not intended to be constructed as an all-inclusive list of all responsibilities and duties. Other duties may be assigned.

1. Assists with the development, scaling, improvement, and maintenance of data models, dashboards, and analytical solutions supporting Peak Health operations.

2. Leverages complex analytical tools to provide business and technical expertise to create data driven solutions.

3. Partners with health plan leadership, product, operations, medical management, and provider contracting teams to understand & anticipate reporting requirements, priorities, and key performance indicators.

4. Provides thought leadership to key business stakeholders, translating data into actionable insights using appropriate analytical solutions.

5. Produces repeatable and ad-hoc reports for key business stakeholders to measure and interpret business trends.

6. Participates in a variety of assigned operations initiatives to ensure success in meeting business goals and objectives.

7. Provides mentoring and guidance to Business Intelligence Engineers on processes and practices related to repeatable and ad-hoc reports, defining business cases, and supporting key business stakeholders.

8. Collects report requirements – interview and research business stakeholder needs; draft, edit and validate requirement documentation.

9. Provides input on project plans, scope of work, status, and project summary reports.

10. Provides input on strategies and tactics regarding platforms, tools, and technical staffing to meet customer needs.

11. Communicates results of analysis effectively and regularly to business stakeholders.

12. Other duties as assigned.

PHYSICAL REQUIREMENTS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. Working on a computer.

WORKING ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. Work will primarily be completed in a remote setting. Occasional travel to office may be required.

SKILLS AND ABILITIES:

1. Strong programming skills with query languages such as SQL and the ability to perform effective querying from multiple tables and databases.

2. Experience with querying tools such as Microsoft SQL Server Management Studio.

3. Experience with data visualization tools such as Tableau or Power BI.

4. Experience working with Oracle, Teradata, Hadoop, etc.

5. Strong problem solving and quantitative abilities.

6. Excellent communication and collaboration skills.

7. Attention to detail.

8. Experience with Commercial (self-funded and fully funded), Medicare, and Medicaid products

9. Working knowledge of claims, utilization management, member, and/or provider data

10. Effective time management and organizational skills

11. Work independently as well as in a team environment

12. Proficient computer skills, including experience with Microsoft Office Suite such as Excel functionality (pivot tables, vlookups, macros, etc.).

Additional Job Description:

Scheduled Weekly Hours:

40

Shift:

Exempt/Non-Exempt:

United States of America (Exempt)

Company:

PHH Peak Health Holdings

Cost Center:

2903 PHH Operational and Provider Analytics