This individual will be responsible for analyzing complex financial and clinical scenarios to support informed decision making including financial, clinical and operational improvements. This person works relatively independently with limited direction and supervision. Responsible for gathering and interpreting claims, clinical and administrative data to build effective financial models, makes reasonable assumptions, and reach appropriate conclusions. Serves as a resource and consultant across the system and sites to design and produce relevant information to inform strategies essential to the success of population health initiatives.

Provides decision support analyses and services to Enterprise Population Health Departments, CINs, RBOs and PHOs, and all levels of management to monitor financial and operational performance. Coordinates analyses with Care Management, Finance, Government Programs, Analytics & Innovations, IT, Quality, Clinical Risk Adjustment and other departments. Prepares analyses and develops routine and special management reports and reporting tools to support ongoing PHO/CIN/RBO operations, finance, care management, clinical risk adjustment, and department management decision making. Works with administrative and physician leadership (site and system).

Analyze total cost of care and payer contract performance using any and all data systems available. Makes specific recommendations to management and physician leadership (site and system) based on the results of these analyses.

Analyze clinical, financial and quality performance by site, by physician, and by contract. Proactively identify areas for analyses, share the information with physician and administrative leadership.

Conduct and present analyses that drive improved delivery of value-based care. Works with IT partners to diagnose, correct, and validate any issues with the data populating business intelligence tools.

Creates efficient presentations of quantitative and qualitative information by minimizing text and appropriately incorporating visual displays. For executive level reports, craft a concise written summary of key report conclusions and clearly translate analyses and visualizations into practical and actionable recommendations. Summarizes analytical findings in ways that business leaders and front line clinicians can quickly understand and use to drive performance improvement.

Assumes responsibility for maintaining current knowledge of government regulations, policies, and trends that affect the health care industry, and independently conduct online research to access documents, pertinent regulations, or to access publicly available datasets.

Licenses & Certifications

None Required.

Degree Required

Bachelor's Degree in Accounting or related field, or

Bachelor's Degree in Business, or

Bachelor's Degree in Health Care Administration, or

Bachelor's Degree in Computer Science.

Required Functional Experience

Typically requires 5+ years of experience in accounting, finance, or analytics experience in health insurance or healthcare fields.

Knowledge, Skills & Abilities

Must have strong analytical skills, advanced Microsoft Office Suite skills specifically in Excel and PowerPoint, and be able to communicate effectively with management and staff at all levels. Advanced analytical skills, including ability to analyze quantitative and qualitative data and reach sound conclusions. Advanced computer skills, including the Microsoft Office Suite especially Excel. Experience with one or more business intelligence tools (e.g. PowerBI, Business Objects, Strata). Good communication skills, including verbal communication and business writing. Working knowledge in healthcare insurance industry, healthcare finances, care management, clinical risk adjustment, and/or physician practices. Good project management and time management skills. Good interpersonal skills, including ability to communicate at all levels within the organization. Experience with Epic preferred. Competent ability to create queries in SQL or other query languages preferred.