Career Opportunities: Healthcare Analyst (24657)

Candidates hired for remote positions must reside in Oregon, Washington, Utah, Idaho, Arizona, Nevada, Texas, Montana, or Wisconsin.

Job Summary

This position is responsible for performing complex research and analysis of healthcare claims, enrollment, and other related data to provide advanced analytics and statistical support, define specifications for quality measures, develop reporting tools, and translate complex data into meaningful information for decision makers.  Analysis focus areas include cost and utilization of health services, financial trending, population health outcomes, and quality of care.  In addition, the position is responsible for ensuring the completeness and integrity of data used for analysis and collaborating across departments within a multi-function, mission critical environment.

Essential Responsibilities

• Develop research methods and data analysis plans related to population health outcomes, quality of care, healthcare utilization, cost trends and financial forecasting.
• Conduct descriptive, prescriptive, predictive analyses and evaluative studies.
• Summarize complex data for leadership in the appropriate form (e.g., statistical summaries, narratives, charts, tables, graphs, etc.) to convey meaning, significance and actionable information.
• Develop visual reporting (e.g., dashboards, scorecards, etc.) using data visualization tools such as Tableau when appropriate.
• Assist leadership to evaluate proposals and opportunities within the provider delivery network.
• Advise management regarding cost and utilization outcomes derived from different payment scenarios.
• Compile and analyze healthcare claims data to define specifications for healthcare quality measures.
• Develop reporting tools to comply with regulatory reporting.
• Use appropriate software tools to retrieve, edit and tabulate data from various databases and files.
• Continually review and assess the completeness, validity, and reliability of internal administrative data used for analysis and reporting.

• Collaborate with other internal teams to develop strong data pipelines and reusable data products.

• Contribute to development of models, algorithms, and analysis tools to mature the use and creation of self-service data products at Care Oregon.

• Create and maintain technical documentation such as data dictionaries, business glossaries, metric definitions, and other data resources.

• Contribute to, and actively participate in, community of practice to improve the skills and capabilities of other analysts at CareOregon.
• Assist with, prepare, and/or deliver presentations to community groups, regulatory agencies, leadership, and other teams as needed.

Organizational Responsibilities

• Perform work in alignment with the organization’s mission, vision and values.
• Support the organization’s commitment to equity, diversity and inclusion by fostering a culture of open mindedness, cultural awareness, compassion and respect for all individuals.
• Strive to meet annual business goals in support of the organization’s strategic goals.
• Adhere to the organization’s policies, procedures and other relevant compliance needs.
• Perform other duties as needed.

Experience and/or Education

Required

• Minimum 5 years’ related experience, including the following:

• Statistical software packages, such as Python, R or SAS
• Writing advanced queries for data manipulation
• At least one Healthcare Data Domain (e.g., Claims, Pharmacy, Clinical, Dental, etc.)

Preferred

• Master’s or bachelor’s degree in STEM, Finance, Economics, Business Administration or Public Health
• Experience planning, implementing, and summarizing complex analysis and reporting project(s)
• Experience with Machine Learning
• Experience with Clustering Algorithms 

Knowledge, Skills and Abilities Required

Knowledge

• Knowledge of Tableau Desktop/Creator or other Business Intelligence applications preferred
• Knowledge of Agile development processes preferred
• Knowledge of the basic concepts of Managed Care and Medicare/Medicaid Programs preferred

• Knowledge of financial matters in the healthcare industry preferred

• Knowledge of medical and/or pharmacy claims preferred

Skills and Abilities

• Advanced skills with statistical software packages, such as Python, R or SAS
• Ability to develop advanced queries to independently gather, compile and analyze data

• Ability to effectively synthesize and present actionable interpretations of complex information to internal and external stakeholders
• Ability to provide leadership and oversight of research and analytical projects
• Excellent critical thinking and problem-solving skills
• Ability and willingness to continually learn new skills
• Ability to manage multiple tasks concurrently
• Excellent written and verbal communication skills
• Ability to work effectively with diverse individuals and groups

• Ability to learn, focus, understand, and evaluate information and determine appropriate actions
• Ability to accept direction and feedback, as well as tolerate and manage stress
• Ability to see, read, and perform repetitive finger and wrist movement for at least 6 hours/day
• Ability to hear and speak clearly for at least 3-6 hours/day

Working Conditions

Work Environment(s):  ☒ Indoor/Office     ☐ Community       ☐ Facilities/Security      ☐ Outdoor Exposure

Member/Patient Facing:    ☒ No                        ☐ Telephonic        ☐ In Person

        Hazards: May include, but not limited to, physical and ergonomic hazards.

Equipment:  General office equipment

Travel:  May include occasional required or optional travel outside of the workplace; the employee’s personal vehicle, local transit or other means of transportation may be used.

#MULTI

Candidates of color are strongly encouraged to apply. CareOregon is committed to building a linguistically and culturally diverse and inclusive work environment.

Veterans are strongly encouraged to apply.

We are an equal opportunity employer. CareOregon considers all candidates regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, disability, or veteran status.

Visa sponsorship is not available at this time.