Research Analyst (Medical Mgmt) - Hybrid (PA/NJ/DE)
Our organization is looking for dynamic individuals who love to learn, thrive on innovation, and are open to exploring new ways to achieve our goals. If this describes you, we want to speak with you. You can help us achieve our vision to lead nationally in innovating equitable whole-person health.
The Research Analyst - Medical Management Performance is responsible for driving consistency in measurement, tracking, and analytics related to provider & clinical experience. The analyst would consult with business stakeholders to identify the business requirements for any project reporting needs, collaborate with Informatics to obtain the necessary data, conduct detailed analyses, and review actionable insights with leadership to support business decision-making.
This position is within the Claims Medical Review team and supports teams across the Medical Management organization
· Work directly with Informatics, BTS, and cross-functional business teams (e.g., HVO, Government Markets, Sales/Marketing, Actuary, etc) to translate clinical & business needs into data & actionable analytics
· Captures, develops, and documents business requirements
· Supports the continuous development, maintenance, and refinement of Medical Management related dashboards
· Works within PowerPoint creating business decks and utilizing data from dashboards to distill into executive summaries.
· Will analyze provider feedback & data from a variety of internal & external sources to understand root causes of provider satisfaction & pain points as well as identify opportunities within the clinical care space
· Identifies trends that impact provider behavior & experience and provide recommendations on how to share strategy and delivery
· Tracks clinical & operational functional metrics to provide feedback and business insights/recommendations to enhance the provider & member experience
· Continuously conduct in-depth review and analysis of provider data across the journey spectrum to surface impacts, trends, and opportunities
· Communicate regularly with internal and external stakeholders.
· Present to internal stakeholders and external partners, summarizing performance results and analytic findings.
· Analyze data and distill into business insights through story telling for leadership review, consumption, and decision-making
· Manage project timelines, monitoring outcomes, evaluating results, summarizing findings, and ensuring data integrity.
· Ensures sound analytical methods.
· Other duties as required.
Knowledge, Skills, and Abilities Required
· Bachelor’s Degree required in related field, Masters preferred
· 1-3 years’ experience in the area of analytics and healthcare
· Proven experience in Microsoft Excel (e.g., VLOOKUP's, pivots, formulas) and PowerPoint
· Proven experience with data analysis and linkage of multiple data sets
· Experience with SQL and Tableau
· Experience with data visualization measurement tools and survey design
· Working knowledge of database frameworks, operational metrics design, and data production lifecycles
· Proven ability to apply quantitative and/or qualitative research and data analysis techniques to improve operational processes
· Ability to interact with business and data management functions and translate between business requirements and data management/measurement capabilities
· Development of keen business insights rooted in an analytic approach
· Strong problem-solving skills
· Excellent communication skills, both written and verbal
· Works independently with minimal guidance
Hybrid
Independence has implemented a “Hybrid” model which consists of Associates working in the office 3 days a week (Tuesday, Wednesday & Thursday) and remotely 2 days a week (Monday & Friday). This role is designated as a role that fits into the “Hybrid” model. While associates may work remotely on our designated remote days, the work must be performed in the Tri-State Area of Delaware, New Jersey or Pennsylvania.
IBX is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.
Must have an Android or iOS device which is compatible with the free Microsoft Authenticator app.
Vaccination Update
This job requires that you demonstrate you have been fully vaccinated for COVID-19 prior to the start of employment, to the extent permitted by law.
About Our Company
AmeriHealth Casualty has been successfully returning employees to work since 1994, providing quality medical treatment and care and reducing costs for our customers. With our affiliates, we serve more than 1,800 businesses in the area and have offices in Philadelphia, Camp Hill, and Pittsburgh, PA, and Mount Laurel, NJ.
In 1994, CompServices, Inc. began offering workers’ compensation third-party administration services for manufacturers, municipalities, health care facilities, social services, transportation risk, universities, and retail firms. In 1996, AmeriHealth Casualty Insurance Company was established as an extension of our workers’ compensation claims services — its mission to provide workers’ compensation insurance combined with high quality claims service and cost containment.
AmeriHealth Casualty Insurance Company and CompServices write premiums and administer self-insured programs for over 1,800 customers.
Equal Employment Opportunity
AmeriHealth Casualty is an Equal Opportunity and Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.
Agency Disclaimer
All resumes submitted directly to an AmeriHealth Casualty employee from a vendor via email, the Internet or in any other form without a valid written search agreement in place for this position from the Independence Blue Cross Family of Companies Human Resources Department will be deemed the sole property of AmeriHealth Casualty and the Independence Blue Cross Family of Companies. Please note that no fee will be paid in the event the candidate is hired by AmeriHealth Casualty or the Independence Blue Cross Family of Companies as a result of the referral or through means other than our established process.