Conduct analysis and data development for a broad range of financial and reporting functions in support of Point32Health. Reporting includes but is not limited to Commercial and Government-sponsored provider reimbursement analytics. This role will work closely with other teams within Network Contracting and Claims Configuration and on cross-departmental workgroups.

Job Description

KEY RESPONSIBILITIES/ESSENTIAL FUNCTIONS

• Produce monthly and/or quarterly performance reports, including drill-down analyses and provider reimbursement materials as needed.
• Perform ad hoc and standard analyses.
• Participate in forecasting and budgeting processes.
• Assist in responding to state and/or federal regulatory requests.
• Provide materials in response to internal and external auditor requests.
• Demonstrate problem-solving aptitude through critique of analytic methodologies and studies completed by peers and third parties
• Exemplify the characteristics of a lifelong learner, consistently seeking additional training and build knowledge/experience of business acumen, tools, languages and data sources
• Act as a Lean Thinker, applying continuous improvement philosophies and approaches to identify and address inefficiencies in your day-to-day work
• Meets assigned timelines and escalates risks/barriers as needed

Requirements

EDUCATION:

Bachelor's degree required.

EXPERIENCE:

• 3-5 years of experience related to data analysis, preferably healthcare related.
• Knowledge of DRG, OPPS, RBRVS and CPT coding concepts helpful.
• Experience with Medicare and Medicaid helpful.

SKILL REQUIREMENTS:

Technical

• Proficiency in the use of personal computers, relational databases, statistical packages, spreadsheet and/or database applications
• Interpretation of contract language relative to reporting requirements.
• Knowledge of SAS, SPSS or SQL based tools preferred.
• Analysis/Interpretation
• Develops analyses and reports to meet defined objectives.
• Examine and interpret results in the context of the specific business questions being addressed.
• Investigates unusual results and offers explanations.

Communication/Presentation

• Well-developed verbal and written skills
• Packages results to demonstrate how the analysis meets project objectives
• Able to facilitate planning and review sessions
• Developing presentation skills, presents mostly within department and to project teams

Independence/Judgment

• Receives regular management oversight of selected tasks, projects and processes
• Increasingly applies own judgment to analytical/technical issues

Interpersonal

• Must be able to work cooperatively as a team member, with regular interface among various levels of staff and management required.

What we build together changes our customer's health for the better. We are looking for talented and innovative people to join our team. Come join us!

Please note: As of January 18, 2022, all employees - including remote employees - must be fully vaccinated. This position will require the successful candidate to show proof of full vaccination against COVID-19. Point32Health is an equal opportunity employer, and will consider reasonable accommodation to those individuals who are unable to be vaccinated consistent with federal, state, and local law.

About Point32Health

The combination of Tufts Health Plan and Harvard Pilgrim Health Care represents the coming together of two of New England's most iconic nonprofit health care companies. Representing nearly 90 years of combined service to our members and the community, together we are building upon our diverse legacies and innovative collaboration by making it our purpose to guide and empower healthier lives for our members - no matter their age, health, race, identity, or income.

That's why we've named our new corporate entity Point32Health. The Point32Health name is inspired by the 32 points on a compass. It speaks to the critical role we play in guiding and empowering the people we serve to achieve healthier lives.

Point32Health is our corporate name. Harvard Pilgrim Health Care, Tufts Health Plan and our other brands will continue to show up as they do today-trusted, high-quality health plans for people across the country.

As Point32Health, we strive to be a different kind of nonprofit health and well-being company, with a broad range of health plans, and innovative tools that make navigating health and well-being easier, guiding our members at every step of their health care journey to better health outcomes. We are committed to providing high-quality and affordable health care, improving the health and wellness of our members, and creating healthier communities across the country.

This job has been posted by TalentBoost on behalf of Point32Health. TalentBoost is committed to the fundamental principle of equal opportunity and equal treatment for every prospective and current employee. It is the policy of TalentBoost not to discriminate based on race, color, national or ethnic origin, ancestry, age, religion, creed, disability, sex and gender, sexual orientation, gender identity and/or expression, military or veteran status, or any other characteristic protected under applicable federal, state or local law.

Req ID : R3593