Lead Data Analyst, Enrollment & Billing - Emblem Health

• Responsible for the analysis of the entire enterprise oversight of Membership and Billing transactional processing.
• Translate data segments into user-friendly models to facilitate the impact of changes and trends.
• Perform hands-on development and maintenance of multiple types of analytical projects/models (e.g. end to end member impact, 360 degree of member experience to drive model focus, vendor performance assessment, letter validation, etc.).
• Serve as subject matter expert in Membership & Billing.
• Work with other functional areas to ensure that groups, members, & billing have been loaded appropriately by running routine reports and validating SLAs are being met by our vendors.
• Utilize knowledge of our enterprise solutions in the various processing systems including claims, provider, and enrollment systems to evaluate our ability to ensure Membership & Billing practices are being adhered to according to our contractual agreements.
• Maintain full understanding of our enterprise business practices, and keep up to date on changes in Membership & Billing process changes.

• Conduct in depth analysis to ensure controls are in place for the enterprise to ensure proper management of our vendors in accordance with practices and requirement as dictated by the organization.
• Work collaboratively with the Department tower leads and Senior level staff in the Enrollment and Billing areas to recommend process changes or enhancements to internal controls by managing trends and highlighting areas of focus.
• Create an interactive model to create on demand dashboards so data is readily available for leadership and staff to enhance and increase reporting capabilities.
• Provide clear and concise detailed written impact of all oversight maintenance reports.
• Perform detailed contract performance on high-risk clients in areas that have the most exposure
• Work on various cost containment initiatives as assigned by Department leadership.
• May provide recommendations on process improvements.
• Perform revenue assessments related to billing and premium payments to understand trends on slow pay clients and possible impact to the organization.
• Perform other ad-hoc duties as assigned or required.

Requirements:

• Bachelor's degree in Mathematics, Business or related major required, Masters' preferred; additional years of experience and/or training/certifications may be considered in lieu of educational requirements
• 5 - 8+ years of relevant experience in Knowledge Management and Improvement, Change Management, and Customer Experience required
• Proficient with SQL required
• Proficient with MS Office (Word, Excel, Access, PowerPoint, Outlook, Teams, etc.), with advance Excel and Access required
• Skill/experience with SAS & FACETS preferred
• Energy, drive and passion for End-to-End excellence and customer experience improvement required
• Excellent collaboration skills and the ability to influence management decisions required
• Strong problem solving and analytical skills that be applied across all types of business problems required
• Strong communication skills (verbal, written, presentation, interpersonal) with all types/levels of audience required
• Solid coaching and mentoring skills to continuously develop staff core competencies at vendors required
• Health Care experience preferred

Additional Information

• Requisition ID: 1000000737
• Hiring Range: $75,000-$125,000