20 days old

Health Plan Analytics Consultant I/II/III/IV- 021063

Excellus Health Plan Inc.
Rochester, NY 14614
  • Job Code
    HEALT006924

PLEASE NOTE: With limited exceptions, our company is requiring all employees to be vaccinated against COVID-19 by Jan. 1, 2022. We also currently mandate vaccinations for employees who enter our buildings. Please keep this in mind when applying for positions at our organization.


Under the direction of Assigned leadership, Health Plan Analytic Consultant has the responsibility to consult with the business/departmental leads and staff to gain an understanding of our business (i.e. lines of business leadership inclusive of Finance, Marketing and Sales, Health Care Network Management (HCNM), Operational Excellence (OpEx), Safety Net (SN) program owners-as applicable). This position extracts, analyzes, shapes and develops reports in ways that can be easily understood. The consultant monitors trends; brings forward opportunities and insights found in the data to the applicable audiences. This position partners with other analytics units (i.e. Analytics and Data) to collaboratively work on predictive modeling opportunities as well as utilize tools/data developed by other analytic units for deeper analysis of claims and other data.


All Levels


  • Develops ongoing knowledge of Health Plans tools and data sources/structures (i.e. Enterprise Data Warehouse (EDW) and/or Medical/Pharmacy Management systems) to accurately pull data.

  • Independently seeks to understand the business/programs and partners at the Health Plan to better understand the business requirements (the why) of the request and applies both knowledge of the business and analytic skills to proactively fulfill request.

  • Prepares, develops, analyzes, shapes and delivers reports in an accurate and timely manner that tell a story including but not limited to health plan cost and utilization trends, monitoring effectiveness of care management programs, clinical variation and data mining to find potential opportunities to better control costs and utilization, as needed.

  • Compiles complex data sets and simplify/tailor according to audience delivering analyses to. Evaluates and processes raw data for user friendly and provides actionable insight (visual and otherwise) to end users.

  • Collaborates with team members, leveraging skill sets across the team and aiding in growth and development as needed.

  • Proactively problem solves, investigates and tactfully brings forward concerns to management and/or business partners with relation to data pulls and analyses, as appropriate.

  • Uses Health Plan defined populations and appropriate analytic tools to pull data set to identify membership (at the highest level) for downstream data analysis of claims, care management programs, etc.

  • Partners with other specialized analytic units (i.e. Business Intelligence) to develop automated production reports, dashboards and cubes for efficiency when appropriate.

  • Builds collaborative relationship across functional teams and other analytic teams across the organization.

  • Manages, organizes and prioritizes tasks for multiple projects with competing deadlines to successful completion.

  • Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies mission and values and adhering to the Corporate Code of Conduct and leading to the Lifetime Way values and beliefs.

  • Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures.

  • Regular and reliable attendance is expected and required.

  • Performs other functions as assigned by management.

Level II - performs all functions of Level I, as well as:


  • Utilizes SAS, Cognos, Microsoft and/or other tools (i.e. DataFlux, Winscp, AQT, etc.) to develop reports as appropriate and in-depth knowledge of either Health Plan EDW (or related claims data sets) or Medical/Pharmacy Management Systems while becoming familiar with the other data sets or systems.

  • Assists in training and mentoring fellow analysts as directed by management.

  • Participates and represents as a subject matter expert (SME) in cross-sectional team meetings or with business partner leads or other departments as needed.

  • Participates on departmental and Health Plan project teams to recommends and/or develops comprehensive data strategies for optimal SAS/BI Tool utilization and connectivity with other BI tools.

  • Devises strategy for producing deliverables, selecting and utilizing the most appropriate analytic tool, as well as, to begin to build process efficiencies.

Level III performs the same functions as Level I and II, as well as:


  • Utilizes all relevant and available tools that optimize reporting efficiency for consumption by business partners and/or provides the business partners the user-friendly tools to run repetitive reports self-service.

  • Uses knowledge of both the claims data sets/warehouses available and the Medical/Pharmacy Management systems to produce reports that tie the information (claims plus health plan or vendor partner management) that illustrates the effectiveness of health plan and provider partner programs as they relate to trend, program development opportunities, value of management programs to be used both internally and externally.

  • Contributes, in partnership with Data Science to develop predictive cost savings models (or other types of models) and to quantify the value and impact of the department management programs (program specific) for business use to both external and internal partners, ultimately helping to sell programs to employer groups, as needed.

  • Provides expertise in relational database concepts to analytics areas, as well as, customers.

  • Seeks out opportunities to train and mentor fellow analysts within the framework of the department.

  • Demonstrates keen judgment on involved and complex assignments; devises methods and procedures to meet unusual conditions and makes original contributions to the solution of very difficult problems.

Level IV performs the same functions as Level I, II, and III, as well as:


  • Recommends to leadership advanced analytic models and/or research that financially impact pricing, cost containment, quality, marketing and risk management functions.

  • Develops large, complex advanced analytic models and performs data mining functions to identify trends in the data and/or opportunities for improved outcomes, as appropriate.

  • Provides consultation, complex performance analysis, and coaching expertise to team member around methods of continuous quality improvement.

  • Fosters a culture of continuous improvement that includes the use of performance data to understand health care cost and utilization trends, clinical and condition management analysis, health care cost containment, data quality measurement, and predictive modeling.

  • Improves visual analytics throughout the organization.

  • Interacts with Health Plan leadership to interpret model output and make business inferences that address strategic needs.

  • Assesses need and opportunity for upgrades to existing or new analytic products (i.e. SAS or Cognos products).

  • Prepares and submits studies for journal publication or presentation at national meetings, as needed.

Minimum Qualifications


NOTE: We include multiple levels of classification differentiated by demonstrated knowledge, skills, and the ability to manage increasingly independent and/or complex assignments, broader responsibility, additional decision making, and in some cases, becoming a resource to others. In addition to using this differentiated approach to place new hires, it also provides guideposts for employee development and promotional opportunities.


All Levels


  • Bachelors degree in Mathematics, Statistics, Medical Informatics, Economics, or related field with a minimum of two years experience in data or information analysis and reporting.

  • Knowledge and applicable use of all tools available to develop analyses, extract information and using the most appropriate tool for the given report is required (i.e. SAS, Cognos, Excel, Access, SPSS, DataFlux, AQT, Winscp, puTTy etc.). Ability to approach data analysis with different data mining techniques, statistical techniques (when applicable).

  • Proficient in using SAS and/or Cognos and Microsoft tools.

  • Working knowledge of Microsoft Office Suite.

  • Knowledge of basic statistical concepts and have strong analytical and problem-solving skills with attention to detail.

  • Demonstrates the ability to take complex data sets and simplify for all audiences to understand through both visual interpretation and highlighting data points of significant impact or potential areas for impactful program development (quality of care and controlling costs).

  • Willingness to develop relationships with partners within the health plan to both understand data requests and help to shape the request for more influential impact.

  • Demonstrates intermediate understanding of healthcare products and operational business knowledge.

  • Demonstrated analytic abilities combined with capabilities for completing projects with minimum degree of supervision.

  • Knowledge of the health care system and experience working with physician or hospital claims/group data preferred. In depth knowledge of product and member desirable.

  • Excellent oral and written communication skills with aptitude for communicating to a variety of audiences.

  • High degree of initiative, proactive attitude and commitment to teamwork.

  • Demonstrated ability to effectively and tactfully relate to internal and external customers.

  • Possess the ability to work collaboratively with requesters and/or business partners. Adaptable to constant industry change and rapidly changing priorities.

Level II same minimum qualifications to Level I, as well as:


  • A minimum of three years analytic experience in Healthcare industry. Masters degree preferred.

  • Knowledge of advance statistical concepts and has strong analytical and problem-solving skills.

  • Demonstrated ability to effectively interact with internal and external customers with particular strength translating user information needs into requirements and delivering high quality results.

  • Must have the ability to work with large datasets (2TB or greater) and integrate large data across multiple sources (structured and unstructured).

  • Strong PC/programming skills including Microsoft Office Suite, VBA, SQL, Power Play and Impromptu and moderate proficiency in SAS required.

  • Strong analytical, diagnostic, and problem-solving abilities with attention to detail.

  • Ability to quickly develop expertise in new application domains and analytic tools.

  • Consistently demonstrated high quality and accuracy of work.

  • Self-motivation, initiative, and an ability to perform under pressure with little supervision.

Level III - same minimum qualifications to Level II, as well as:


  • A minimum of five years experience using statistical concepts and tools.

  • Masters Degree with at least two years of statistical analysis preferred.

  • Demonstrated expertise in relational database concepts.

  • Demonstrates advanced statistical capabilities, data mining, forecasting and predictive modeling skills, and/or actuarial techniques.

  • Demonstrated skills in quality principles especially root cause analysis and problem solving.

  • Demonstrated business and technical problem-solving skills.

  • Extensive experience in analytic tools required (i.e. SAS, Cognos, SPSS, or others).

Level IV - same minimum qualifications to Level III, as well as:


  • A minimum of three years health care specific predictive modeling experience or seven years of experience in health informatics.

  • MS or MA in Statistics, Economics or related discipline preferred.

  • Ability to create, develop/validate models independently.

  • SAS Base Certification required. SAS Advanced Certification preferred or similar Analytic Software certification.

  • Project Management/Process Improvement knowledge preferred.

  • Continued professional growth in analytic software tools (i.e. SAS competency as evidenced by successful passing of Advanced Certification Exam and/or Certified Predictive Modeler Exam)

  • Project Management (PMP, Six Sigma) experience desired.

  • Advanced analytic software programming proficiency required (i.e. experience with SAS EBI suite, Information Maps, Stored Processes, Web Report Studio, Information Delivery Portal.)

************


The Lifetime Healthcare Companies aims to attract the best talent from diverse socioeconomic, cultural and experiential backgrounds, to diversify our workforce and best reflect the communities we serve.


Our mission is to foster an environment where diversity and inclusion are explicitly recognized as fundamental parts of our organizational culture. We believe that diversity of thought and background drives innovation which enables us to provide leading-edge healthcare insurance and services. With that mission in mind, we recruit the best candidates from all communities, to diversify and strengthen our workforce.


OUR COMPANY CULTURE:


Employees are united by our Lifetime Way Values & Behaviors that include compassion, pride, excellence, innovation and having fun! We aim to be an employer of choice by valuing workforce diversity, innovative thinking, employee development, and by offering competitive compensation and benefits.


In support of the Americans with Disabilities Act, this job description lists only those responsibilities and qualifications deemed essential to the position.


Equal Opportunity Employer

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractors legal duty to furnish information. 41 CFR 60-1.35(c)

Non Manager





Posted: 2021-10-08 Expires: 2021-11-06
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Health Plan Analytics Consultant I/II/III/IV- 021063

Excellus Health Plan Inc.
Rochester, NY 14614

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