Job Summary: 

• Assess and interpret customer needs and requirements
• Identify solutions to non-standard requests and problems
• Solve moderately complex problems and/or conduct moderately complex analyses
• Work with minimal guidance and seek guidance on only the most complex tasks
• Translate concepts into practice
• Provide explanations and information to others on difficult issues
• Coach, provide feedback, and guide others
• Act as a resource for others with less experience
• Maintain alignment of expectations and priorities in an autonomous fashion
• Display and interpret data using visualization tools

Skills on Resume: 

• Customer Needs Assessment (Soft Skills)
• Problem-Solving (Hard Skills)
• Analytical Thinking (Hard Skills)
• Self-Management (Soft Skills)
• Conceptual Translation (Soft Skills)
• Communication (Soft Skills)
• Coaching and Feedback (Soft Skills)
• Data Visualization (Hard Skills)

Job Summary: 

• Analyze claims data and identify trend and outlier patterns that lead to payment integrity interventions
• Develop, implement, and communicate savings methodologies for unique interventions
• Direct data analysts in supporting routine reporting and analytics resources for key customers
• Translate key business partner analytic needs into technical requirements for data analysts
• Present data analyses and key findings
• Examine and identify data patterns and trends to help answer business questions and improve decision-making.
• Perform analytic research, experience studies, and statistical analyses and calculations.
• Research and apply knowledge of existing and emerging statistical and data science principles, theories, and techniques.
• Explain analysis to technical and non-technical audiences of both internal and external customers, including senior leadership and physicians.
• Make proficient use of spreadsheets (Excel), programming languages (SQL, R, Python, etc.), and other relevant software to gather and manipulate data and complete modeling tasks.

Skills on Resume: 

• Claims Analysis (Hard Skills)
• Savings Methodology (Hard Skills)
• Team Leadership (Soft Skills)
• Requirements Translation (Hard Skills)
• Data Presentation (Soft Skills)
• Statistical Analysis (Hard Skills)
• Data Science Research (Hard Skills)
• Data Modeling (Hard Skills)

Job Summary: 

• Identify, monitor, and analyze principal health care cost drivers, by market segment and/or by provider, including utilization, referral patterns, and reimbursement rates
• Research, analyze data, present results, and recommend intelligent solutions to solve problems and address business challenges by applying a knowledge of medical claims analysis, critical-thinking skills, and healthcare experience/expertise
• Analyze claims, membership, and prior authorization data sources to identify early signs of trends or other issues related to medical care costs and quality of care
• Structure analytical results in an organized, visual manner to tell a meaningful, actionable story
• Apply strong critical thinking skills to anticipate questions from key stakeholders and consider all aspects of an analysis before completion
• Write SQL queries, create end-user reports, and apply varying analytical techniques to solve specific business problems
• Determine the credibility and usability of claims data before the delivery of analytic results
• Exhibit initiative in exploring and discovering opportunities to improve corporate performance through data analysis
• Take responsibility for ad-hoc client and market requests
• Interpret contractual language with a clear understanding of business rules and reporting requirements
• Establish trusting professional relationships with internal senior business customers

Skills on Resume: 

• Cost Driver Analysis (Hard Skills)
• Data Research & Analysis (Hard Skills)
• Trend Identification (Hard Skills)
• Data Visualization (Hard Skills)
• Critical Thinking (Soft Skills)
• SQL Reporting (Hard Skills)
• Data Credibility Evaluation (Hard Skills)
• Client Relationship Building (Soft Skills)