|The Manager will report directly to the Director of Health Care Analytics, in support of all Health Care Analytics functions and needs. Responsibilities include:
-Production of monthly and ad hoc health care reports; management of report requests and tracking of progress and completion dates
-Health care reporting for compliance with requirements of DHCS, CMS, L.A. Care Plan Partners, contracted providers, County of Los Angeles, and other revenue or payment sources
-Work with IT and data warehousing counterparts to develop and design deliverables to support the customer reporting needs including actuaries and finance department.
-Legal services support
-Creating and delivering results in an accurate and timely manner to both internal and external customers.
-Conduct baseline and trend analyses for targeted medical cost categories, geographies and segments.
-Apply analytic concepts and tools to enhance understanding of membership, utilization and cost trends across networks, products and geography.
-Validate findings across multiple data sources.
-Use financial analytics to establish IBNR accruals.
-Effectively communicate results to key stakeholders and policy makers. Communication of results include clean and well organized presentations, both oral and written, to reflect analytic methods used, key decision points with sufficient detail to support comprehension and replication of the analysis.
-Daily staff supervision, monitoring and oversight.
-Other support of the Director of Health Care Analytics as directed.
|QUALIFICATIONS & REQUIREMENTS
BA/BS degree (a Master’s degree is preferred) in finance, economics, statistics or other quantitative background.
Master’s degree is preferred in finance, economics, statistics or other quantitative background.
-7 to 10 years of progressive, analytical experience or equivalent in a healthcare setting.
-A minimum of 4-8 years experience managing analysts required.
-Strong analytic, presentation, and communication capabilities; interpersonal skills.
-Strong understanding of managed care metrics (PMPM, Utilization/K and Average Cost).
-Extensive experience using data directly from a database, not simply through a present reporting GUI.
-Strong understanding of claims and membership data from Commercial, Medicaid and Medicare organizations.
-Working knowledge of managed health care, data analysis,
-MS Office applications
-Experience working with both internal and external customers.
-Demonstrate problem solving and critical thinking skills.
-Strong organizational and time management skills.
Current or prior experience with managed health care plans.