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This position leads data analytics and insight for a local healthcare coalition. Managing and interpreting healthcare data to support provider contracting, business development, and member experience are primary responsibilities. The Business Intelligence Analyst ensures compliance with all regulatory requirements and provides reporting to assist the President & CEO in strategic planning and best practice business procedures. This position is the liaison between software vendors, the organization and its’ members. Management and configuration of internal and vendor software is a core function.
ACCOUNTABILITIES
Responsible for compliance with all data management and reporting regulations.
Data Analytics:
Analyzing data to identify trends, patterns, and insights that can inform strategic decisions.
Interpreting data to support provider contracting and healthcare provider pricing activities and administration of a managed care network; leads the analysis and reporting of healthcare quality, cost and utilization data.
Collect, analyze and interpret health care data to develop network discount analyses, utilization, cost and quality analyses or other benchmarking analyses and reports.
Manage data collection process for provider contract renewals or pricing: gather, organize, and summarize data; Provide analytical support for managed care network development, including provider pricing and contract base analyses, results summaries and recommendations and assist in other PPO contracting activities as directed. Provide reports and financial analysis/prep to support negotiations.
Predictive analytics, estimate future network costs and develop pricing models and data analysis.
Management and configuration of internal and vendor software.
Evaluation of technology business partners and industry opportunities such as AI.
Establishes key metrics and reporting that provides valuable data to members.
Manages website; updating and ensuring accuracy of information posted publicly.
Develop and generate standard claims repricing reporting; Create data summary reports.
Conduct network performance/administration analysis and prepare network administrative tools.
Work with Request for Proposal (RFP) team on RFP responses and related issues; Review proposal responses for reasonableness, accuracy, and meeting requirements.
Develop awareness of health care plan design, cost factors and the renewal process.
Conduct service area analysis and reporting which may include analyses such as GeoAccess analysis and other provider access analysis.
Complete special projects and ad hoc report requests as assigned.
Other duties as assigned.
GENERAL INFORMATION
Bachelor’s degree in accounting, finance, business administration, mathematics, economics, statistics or related field required. Master’s Degree Preferred.
Prior healthcare finance or managed care reimbursement experience preferred.
Prior healthcare information technology experience preferred.
Excellent quantitative, analytical, database, and spreadsheet utilization skills required with strong orientation to detail and complex problem solving skills.
Strong experience with managed care and governmental reimbursement methodologies, healthcare financial analysis.
Experience in healthcare industry regulations is required.
Excellent interpersonal skills; strong oral and written communication skills with the ability to communicate effectively with a variety of audiences.
Ability to prioritize and perform several tasks/projects simultaneously with attention to detail.
Ability to work independently and on a team.
Successful track record of managing multiple deadlines.
The above list of duties is intended to describe the general nature and level of work performed by the incumbent. It is not to be construed as an exhaustive list of duties performed by the incumbent.
Position Overview/ Ad for position.
FrontPath Health Coalition is a mission-based, not-for-profit provider network spanning across Northwest Ohio, Southeastern Michigan, and Northeastern Indiana. FrontPath is a member-focused coalition dedicated to providing flexible and cost-effective benefit solutions to health plan sponsors in collaboration with our broad network of providers.
FrontPath is committed to reducing health costs for the community by preserving access to quality care at a fair price. This position is located in Perrysburg, Ohio and reports directly to the President & CEO.
This is a unique opportunity for the right candidate to join an expanding organization and influence strategic direction, growth, and coalition member satisfaction. To be considered for this position please send a resume and interest letter to: careers@frontpathcoalition.com
Qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, religion, sex/gender (including pregnancy), sexual orientation, gender identity or gender expression, age, physical or mental disability, military or protected veteran status, citizenship, familial or marital status, genetics, or any other legally protected category. In compliance with the Americans with Disabilities Act Amendment Act (ADAAA), if you have a disability and would like to request an accommodation in order to apply for a job please send an email to careers@frontpathcoalition.com.