Seeking a Senior Level Healthcare Provider Network Analytics Professional! The selected candidate will provide analytical support to our clients Healthcare Network Management and Contracting Division in support of the onsite Actuary. This role will be deeply involved in the analytical processes that drive executive business decisions related to our client's provider network and health plan management services. You will be challenged to think creatively and develop data-driven solutions to complex problems facing the healthcare industry. This role will report to the Manager & Lead Actuary.
Primary Responsibilities
- Collaborate with Network Management and Contracting to provide ongoing analytical support.
- Develop and maintain forecasting models, and analytical reports and dashboards.
- Develop actionable data insights that inform network strategy.
- Support financial and actuarial components of product and network development, including evaluation of new products.
- Conduct analysis specific to the medical economics underlying provider financial arrangements in support of new business, client and provider retention efforts.
- Provide financial analysis for more complex and/or larger health plan clients, such as alternative provider network configurations.
- Perform medical cost trend analysis and identify cost savings opportunities.
- Evaluate provider networks based on available benchmarks and published data sources.
This position is a fulltime, direct opportunity with our Healthcare client who is offering a generous salary and benefits package. Ideal work location is Westbury NY (Long Island) with a hybrid schedule (3 days onsite). Alternatively, this position can be staffed remotely for candidates that reside in one of the following states: CO, CT, FL, GA, IL, MA, MD, MI, MN, MO, NC, NJ, NY, OH, PA, SC, TN, TX, WA.
- Bachelor's Degree in Mathematics, Statistics, Finance, Computer Science, Information Systems, Data Science, Analytics, Engineering, Economic Sciences, Actuarial Science or related field is Required
- 7+ years of experience in an analytical or actuarial focused capacity at a health plan or consulting firm required, preferably in a managed care setting.
- Proficiency in SQL and Microsoft SQL Server Suite of Products (SSMS) required.
- Proficiency in MS Excel required.
- Experience with Business Intelligence applications and DAX functions (PowerPivot, Power BI, Tableau) a plus.
- Experience with evaluating carrier rates using external sources (i.e. MRFs) a plus.
- Experience with alternative payment models (i.e. value-based payment models, bundled payment arrangements) a plus.
- Excellent quantitative and problem-solving skills.
- Excellent oral and written communications skills.
- Ability to exercise professional judgement independently.
- Ability to explain technical concepts to a non-technical audience.
- Ability to effectively manage and prioritize several concurrent projects.
Remote or Westbury, NY
1
Monday, August 26, 2024
Direct Hire
Direct Placement
Wednesday, July 17, 2024
Know someone who would be a good fit? We pay for referrals!