Senior Payer Analytics Analyst - SCA Health

Overview:

Today, SCA Health has grown to 11,000 teammates who care for 1 million patients each year and support physician specialists holistically in many aspects of patient care. Together, our teammates create value in specialty care by aligning physicians, health plans and health systems around a common goal: delivering on the quadruple aim of high-quality outcomes and a better experience for patients and providers, all at a lower total cost of care.

 

As part of Optum, we participate in an integrated care delivery system that enables us to support our partners as they navigate a complex healthcare environment, Only SCA Health has a dynamic group of physician-driven, specialty care businesses that allows us to customize solutions, no matter the need or challenge:

• We connect patients to physicians in new and differentiated ways as part of Optum and with our new Specialty Management Solutions business.
• We have pioneered a physician-led, multi-site model of practice solutions that restores physician agency by aligning incentives to support growth and transition to value-based care.
• We lead the industry in value-based payment solutions through our Global 1 bundled payment convener, that provides easy predictable billing to patients.
• We help physicians address everything beyond surgical procedures, including anesthesia and ancillary service lines.

 

The new SCA Health represents who we are today and where we are going—and the growing career opportunities for YOU.

Accountabilities / Responsibilities:

SCA Health is currently seeking a Senior Payer Analytics Analyst on the Catalyst Analytics team.  We are seeking a candidate who is excited to take a thoughtful approach to examine and organize complex data for multiple ASC contract and development negotiations.  Moreover, we are seeking an analyst with an investigative mindset to explore nuances of the data and use data to drive decisions through report preparation and analysis.

This position will be remote.

 

Responsibilities:

 

• Partner with contract negotiators to identify key variables and preliminary strategies for upcoming projects, then generate accurate and instructive analytical models that reflect these inputs
• Collaborate with regional business development leaders to evaluate potential acquisitions, using a combination of external and internal claims data
• Support cross-functional team members with development, implementation, and maintenance of operational reports and analytical dashboards
• Help design and implement improvements to established or proposed reimbursement process.
• Develop effective quality control processes to ensure data integrity
• Review claims data to ensure accurate and adequate payment
• Ask thoughtful questions about execution and business context across different lanes
• Present ideas and participate in meetings - Actively seek new opportunities to contribute
• Retrieve, organize, and manipulate data from the Enterprise Data Warehouse and other databases to prepare data for reporting and analysis. Deliver actionable, supportable findings within tight deadlines and changing requirements.
• Uphold and practice the principles and policies of the SCA Compliance program

 

Qualifications:

 

 

• Bachelor's degree in Actuarial Science, Mathematics, Statistics, Economics or related field
• 3+ years of analytical experience in a Healthcare/Managed Care environment required
• Travel to company meetings (10%)
• MS SQL Server (Strong command over T-SQL) required
• Advanced experience in Excel
• Experience in hospital, health plan, risk-based care delivery organizations or physician claims analytics
• Experience working with large healthcare claims data
• Clinical code knowledge (ICD, CPT, Rev Codes, etc.) related to medical claims/utilization data strongly preferred
• Tableau BI tool experience preferred
• Acute attention to detail and strong analytical and critical thinking skills
• Experience with managed care contract terms analysis
• Strong written and verbal communication skills including the ability to communicate results of data analysis to a variety of stakeholders

 

Min:USD $67,950.00/Yr.Max:USD $85,000.00/Yr.