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Senior Financial Health Care Data Analyst

at HMSA

Posted: 10/2/2019
Job Reference #: 5000524880306

Job Description

Employment Type

Full-time

Exempt or Non-Exempt

Exempt

Job Summary

Provide subject matter expertise and project team leadership to the Health Services Division and Finance Division. Utilizing data from multiple sources provide statistical data analysis, reconciliation reports, and drive the development of integrated, comprehensive reports to support the management of the quality and cost of health care. Efforts include, but are not limited to, evaluation of quality improvement initiatives, the effectiveness of various health programs, provider negotiations, and clinical outcomes.

Minimum Qualifications

 
  • Bachelor's degree and five years of related work experience; or equivalent combination of education and experience
  • May require travel to other centers including those on the Neighbor Islands.
  • Proficiency in Microsoft Office.
  • Demonstrated understanding of data analytics & process improvement.
  • Knowledge of basic relevant statistical analyses.
  • Proficiency in problem solving and data collection, analysis, and interpretation.
  • Ability to communicate (oral and written) with management, providers, vendors, and other employees.
  • Demonstrated ability to interact successfully with all levels of management.
  • Strong organization and time management skills
 

Duties and Responsibilities

A) Cross-Functional Project Team Leadership and Participation: Assist executives, project staff and subject matter experts with the planning and implementation of project and sub-project work efforts

  • Lead, coordinate, facilitate, and/or participate in cross functional teams to plan and complete complex corporate projects such as bundling for specialty providers intended to design or evaluate:
    • Quality Improvement initiatives
    • Health Prigrans & Clinical Outcomes
    • Areas of opportunity or risk for specific lines of business
    • Action plans for risk mitigation
  • Bring a whole-company perspective to ensure the delivery of holistic department and/or corporate solutions.
  • Provide information and training on data elements, systems or analytic methodologies to other analys within the department and other units.
  • Manage ongoing project dynamics to ensure successful completion and impact.
B) Data Management, Research and Analysis: Conduct research, design and use algorithms and specific skills in quality improvement, medical statistics and financing, applying sound knowledge of statistical theory and its application to research methodology
 
  • Primarily responsible for all data analysis from various sources to provide statistical data for financial modeling, quality improvement research and reporting for physicians and providing actionable data and reports to improve cost and quality of care. Ensures feasibility and evaluates reliability of data source information, conducts analysis of statistical data sets, interprets statistics and identifies significant relationships, and organizes results into a compatible and useful format to prepare conclusions and forecasts based on data summaries
  • Analyzes claims data information and utilizes predictive algorithms to develop recommendations regarding interventions for health services programs, including quality improvement programs, health/disease management, population health management, and utilization management
  • Develops reporting tools and maintains various database programs, including financial and clinical data, to analyze, track, review and support a variety of medical management activities.
  • Based on derived results, translate data and create analytical presentations using tables, graphs, charts, written report or other methods
  • Produce written project and study reports in a structured and informative manner
 
C) Cross-Functional Integration and Communication: Creates and fosters working relationships with internal staff and external business partners to complete deliverables
 
  • Collaborates and works with internal subject matter experts and support staff.
  • Collaborates and works with external customers and clients to evaluate business needs.
  • Design reports to deliver data and information that will address and improve business needs.
  • Communicates clearly and concisely task specifications, status and completion
  • Collaborates with other staff and management to complete assigned duties and objectives, facilitate communications and resolve problems and issues quickly, tactfully, and positively.Present data and information in a clear, concise and appropriate-to-the-audience manner
 
D) Data Systems & Applications Management: In conjunction with the Direction of Executive staff will evaluate and participate in possible future tools that will lead HMSA for implementing strategies on the Hospital area for new reimbursement methodologies to help shape the corporate goals
 
  • Analyzes existing applications and/or designs new computing services or systems to complete data analyses and reporting required to meet changing goals. Incorporates computing concepts, theories, new technologies, and architectures and applies knowledge of computing trends, company business objectives, and customer requirements.
  • Evaluate system options; make recommendations, providing input and technical guidance. Develop necessary project plans for implementation to lead and coordinate problem tracking, resolution, and verification testing, as needed
 
 
 
E) Project Management:
 
  • Provide mentoring and guidance to junior analysts in the department to ensure analysis framework, data elements, execution, reporting and presentations are appropriate, accurate, concise, clearly stated and appropriate for internal and external audiences and all levels of staff.

  • Manage project deliverables based on business needs and assigned responsibilities.

    • Gathers business requirements to determine timelines.

    • Conduct ongoing reassessment to reprioritize as needed and to make corrections to assure measures hit short and long term goals.

    • Ensure project progresses on schedule within prescribed budget guidelines.

  • Complete system and data analysis procedure documentation that supports each research study, project and/or reporting system that is implemented. Assists in internal and external publication of research studies. Provides technical coaching and mentoring to other team members.
  • Perform cost/benefit analysis that supports business operations and project management. Assist to define solutions that support business flows through use of workflow design/redesign
 
 
F) Other Duties/Functions:
 
 
  • Other duties as assigned.
  • Serve as a team player and role model for other employees in the organization by always exhibiting traits of courtesy, caring, helpfulness, and respect; conducts oneself in a service-oriented manner that is attentive, pleasant, cooperative, sensitive, respectful, and kind when dealing with members, visitors, the public, and all employees.