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Data Analyst
Location : California, Orange
Refer job # VNJQ340824

Job Responsibilities and Requirements: Position Responsibilities: Generate new and existing UM reports on defined schedule and on an ad hoc basis. Model new UM metrics or changes in methodology. Coordinate with Enterprise Analytics and Information Services to ensure consistency in query design. Prepare reports and findings in a clear and concise manner, both written and verbal. Evaluate reports for accuracy of data, including the application of standardized analysis, and assist in the timely production of reports. Provide analysis regarding trends in the data compared to industry standards and recognized benchmarks. Provide technical expertise in analysis to staff, other departments, and agencies working in conjunction with . Provide support and prepare data with analysis for the UM workgroup and UM Committee. Assist in the implementation of integrated strategies to improve data collection and data integration. Work with systems staff to ensure functional effectiveness of the interactions between operations and information systems. Ad-hoc analyses, special projects, and other duties as assigned by management. Required Skills Meet and maintain established quality and production standards. Work independently and as part of a team, with multiple deadlines and minimal supervision. Develop and maintain effective working relationships with all levels of the Medical Affairs, Enterprise Analytics, and Information Services (IS) staff, other departments and various external customers. Present information in a user-friendly format and be able to clearly analyze and explain content. Communicate, both written and verbally, in a clear and concise manner. Work with complex databases: build queries and reports, format reports, export reports, etc. Required Experience Experience & Education: Bachelor s degree in Health Care Administration, Business Administration, Mathematics, Public Health or a related field required. Master s degree preferred. Health care administration experience that would have developed the knowledge and abilities listed is required. 3-5 years professional experience in a managed health care organization is required, including Medicaid and/or Medicare populations. Prior experience with business intelligence data integration and proven ability to conduct root cause analysis preferred. Knowledge of: Structure of managed care delegation models: direct, partial and full, as well as the key metrics applicable to each model. Data retrieval from data warehouses and databases; with experience in trending and aggregating both units and rates. Basic SQL and experience with data mining tools such as Tableau, Business Objects and SAS required. Medicare/Medi-Cal guidelines, regulations and data reporting requirements. Utilization Management principles and processes. Advanced knowledge of Microsoft Office products including Word, Excel, Outlook, Access and VBA (Visual Basic for Applications.); Excel with the ability to manipulate data and produce charts and reports. Excellent organizational skills and the ability to prioritize tasks and use time efficiently. High-level data quality assessment and analysis skills. Strong oral and written communication skills. Medical coding, including ICD9/ICD10, CPT, and HCPCS codes recommended.



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