Member Services Data Analyst – Health Plan

Location: Santa Barbara, CA
Date Posted: 06-29-2018
CareNational
Member Services Data Analyst – Managed Care
Santa Barbara, CA
  
Your Job Summary: 

The Member Services Data Analyst is responsible for providing customer-focused analytical services to the Member Services and Quality Improvement teams. The position collaborates with the leadership to develop and maintain processes and tools for measuring performance; performs basic and complex analyses to monitor health care quality, fiscal soundness, and return on investment; supports compliance with regulatory reporting standards and continually stimulates organizational improvement. The position also promotes data integrity through development and improvement of methods to collect data, and may identify and/or develop intuitive easy-to-use self-service point and click applications to increase the effectiveness of clinical quality oversight systems.

Your Reward:   

EXCELLENT BENEFITS AND HIGHLY COMPETITIVE SALARY OFFERED!
Work with an exceptional organization focused exclusively on promoting the health care and quality of life for its members.  The forward-looking health plan has a demonstrated passion for finding innovative ways to enhance member’s ability to manage their own health.

Your Background:  
 
Requires an education level of at least a Bachelor’s degree in business, health care, data analytics, or related field. 
Prefer professional certification in a technical discipline (SQL, Cognos, etc.).
At least 3-4 years experience in a medical office, hospital or health plan call center, or other healthcare support role with heavy computer & database use.
Significant experience analyzing large volumes of data using PC-based software applications, including Microsoft Excel, including 1-3 years experience using SQL to extract data from a data warehouse.
Strongly prefer 1 or more years at a Managed Care Organization (Health Plan, IPA/Medical Group, HMO, TPA/MSO, etc).
Significant analytical skills and experience analyzing utilization data using PC-based software applications including Excel.
Understanding of Member Services management strategies and analytical approaches to support such strategies.
Understanding of how to measure and monitor service and quality metrics associated with managed care operations.
Basic knowledge of health care delivery systems, Managed Care Organizations as well as Medicaid/Medicare and related state programs is needed. 
Proficient in Microsoft Office applications, with demonstrable skills in Access and Excel, and the ability to learn new and complex computer system applications.
 
Your Duties:
  • Provide dedicated analytical support to Member Services management team
  • Assist in the development and implementation of solutions to continually support Member Services management to meet ongoing strategic objectives
  • Collaborate with leadership to implement processes to achieve and monitor operational effectiveness and efficiency
  • Supply information for strategic decision-making and oversight to stimulate operational improvement and assure regulatory compliance
  • Provide customer-focused project management and analytical services to the Member Services team
  • Collaborate with Member Services management to support measurement of industry standard process and outcome indicators, identification and elimination of barriers to improvement, and identification of appropriate interventions
  • Instruct staff in the use of reporting and specific support tools to independently analyze and use data to stimulate and achieve improvement
  • Assist Director in leading activities to implement tactics and achieve strategic objectives
  • Verify data gathering processes and the accuracy and validity of analyses provided to internal and/or external customers
 
KAYLA ROGERS
ACCOUNT MANAGER
CareNational
kayla@carenational.com
623.201.8732 (CALL – TEXT – FAX)
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