Provider Strategy Analytics Consultant

Company :

Highmark Health

Job Description : 

JOB SUMMARY

This position is responsible for using analytics and reporting to drive program recommendations and assessments related to healthcare services interventions. Directly supports strategic and anchor providers in value-based reimbursement (VBR) contracts with data, reports, and platforms used to promote improved provider quality and reduced cost of care. Collaborates with matrixed partners to understand and effectively explain and support advanced and custom VBR arrangements. Will serve as the main contact for internal and external data and reporting needs. The individual demonstrates strong proficiency in the health care industry and in data analytics.

ESSENTIAL RESPONSIBILITIES

• Drives departmental innovation, including reporting, analysis and presentation materials. Researches and recommends innovative and new data solutions to effectively meet both provider and plan objectives with efficient, accurate and standardized data analyses and related deliverables. Leverage automation to greatest extent possible. 
• Subject matter experts in True Performance cost and utilization reporting. Train and support internal partners as needed. 
• Fosters a strong relationship between internal Highmark teams. Serves as the internal point person  on issues related to reports and reporting tools. 
• Demonstrates opportunities to manage medical costs and improve performance in VBR programs; especially cost and utilization. Makes recommendations on programs to manage costs and improve performance through targeted reports and guidance. 
• Analyzes available data from multiple sources to encourage improved performance to provider teams. Interprets complex data for external provider partners. Collaborates with inter-departmental teams to provide data support for a comprehensive and aligned presentation that highlights opportunities for improvement. 
• Supports Living Health solutions, Right Care, new value-based reimbursement programs and/or performs other related duties as needed. 
• Other duties as assigned or requested.

EDUCATION

Required

• Bachelor's Degree in a Clinical, Finance, or Healthcare related field

Substitutions

• None

Preferred

• Master's Degree in Healthcare Analytics

EXPERIENCE

Required

• 5 years in Project management and/or other job related professional experience

Preferred

• Experience in externally facing consulting and presenting
• Experience in provider office settings

LICENSES or CERTIFICATIONS

Required

• None

Preferred

• None

SKILLS

• Proficient with Microsoft Office products including Excel, Power Point, Word and Access.
• Capable of developing in data visualization and analytic software such as Tableau, Power BI, Excel including the Excel Developer tab and/or Rstudio.
• Basic understanding of SQL / querying capabilities.
• Experience with end-user reporting tools.
• Strong written and verbal communication skills.
• Effective participation in team-based work.
• Ability to understand business needs to master new skills and technologies.
• Must have strong interpersonal skills and the ability to establish, develop and maintain cross-functional business relationships.
• Strong math, analytical, project management and problem-solving skills.
• Self-motivated, autonomous, excellent organizational skills, time management skills and attention to detail. 
• Able to accurately assess client reporting needs, provide effective solutions, offer actionable advice and assist in driving forth the implementation.
• High degree of business maturity and demonstrated confidentiality.
• Capable of identifying gaps in data or identifying actionable opportunities for the purpose of creating a new report or data visualization to meet internal and external customer needs.

Language (Other than English):

None

Travel Requirement:

0% - 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type

Office-based

Teaches / trains others regularly

Occasionally

Travel regularly from the office to various work sites or from site-to-site

Occasionally

Works primarily out-of-the office selling products/services (sales employees)

Rarely

Physical work site required

Yes

Lifting: up to 10 pounds

Constantly

Lifting: 10 to 25 pounds

Occasionally

Lifting: 25 to 50 pounds

Rarely

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement : This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times.  In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy. 

Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability. 

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