Healthcare Reporting Analyst (Managed Care)

WELLBE INTRODUCTION

The WellBe care model is a Physician Led Advanced Practice geriatric care (care of older adults) team focused on the care of the frail, poly-chronic, elderly Medicare Advantage patients.  This population is typically underserved and very challenged with access to care.   To address these problems, we have elected to bring the care to the patient, instead of trying to bring the patient to the care. Care is provided throughout the entire continuum of care – from chronic care and urgent care in the home, to hospital, to skilled nursing facility, to assisted living, to palliative care, to end of life care.  WellBe's physician/advanced practicing clinician led geriatric care teams’ partner with the patient’s primary care physician to provide concierge level geriatric medical care and social support in the home as well as delivering and coordinating across the entire care continuum.

GENERAL SUMMARY

This role will advance WellBe’s understanding of our patient's healthcare utilization and how we can reduce unnecessary healthcare costs while achieving better patient outcomes, and patient experience. The ideal candidate will have a solid knowledge/understanding of healthcare data sets, including medical claims, HCC, HEDIS, and be detailed oriented.  This role reports to the VP Analytics & Reporting and works closely with operational and clinical leaders. Responsibilities include collaborating with operational and clinical leaders to design reports and dashboards to answer key questions about our care model, complete analyses leveraging medical claims, EMR inputs, patient attributions, and healthcare operations data sets.   Identify key insights and communicate with various stakeholders through the WellBe organization.   

SKILLS & COMPETENCIES

• Gather, process, and analyze healthcare datasets using SQL, advanced statistical methods, and leveraging healthcare domain expertise to generate insights and opportunities
• Create reports, presentations, and dashboards to communicate findings to the appropriate Clinical and Operational leader
• Regularly examine data reports to locate and resolve any issues throughout
• Accurately analyze reports, identifying changes and key trends, then effectively communicate findings management
• Other tasks needed to accomplish team’s objectives/goals

Educational/Experience Requirements:

• A Bachelor’s degree or an equivalent combination of education, training and experience as a Financials or Business Analyst is required (Masters Preferred)
• 5+ years of Physician Organization or Health Plan, Hospital Finance, and/or Health Plan experience (operations, objectives, processes, and information flow)
• 5+ years Medicare Advantage experience preferred
• 5+ years’ experience with SQL, Tableau, Python

Required Skills and Abilities:

• Ideal candidate must possess strong SQL, statistical, and presentation skills
• Must be highly analytical & possess a strong grasp of healthcare utilization and medical claims
• Work accurately and efficiently, meet deadlines under pressure and provide actionable reporting is required
• Detail-oriented, tendency to pay close attention to small details that could impact results
• Ability to communicate clearly and effectively
• Maintains information in a confidential manner and complies with HIPAA laws according to policy

Work Conditions:

This position will work in a variety of settings, e.g. office. The noise level in the work environment is usually moderate.   Requires prolonged sitting.  Requires bending, stooping, twisting, kneeling, crouching, crawling and/or stretching from seated or standing positions. Requires eye-hand coordination and manual dexterity sufficient to operate medical equipment, frequently operates a keyboard, telephone, copier, calculator, and other office equipment.  Manual dexterity and coordination necessary to operate office equipment, telephone, keyboard, copier, and calculator.  Requires close vision, peripheral vision, and ability to adjust visual focus, hearing and smelling.  Must be able to communicate information via telephone or computer.  Requires moderate to intense concentration due to complexity.  Must be able to lift and/or move up to 25 lbs.

The preceding functions may not be comprehensive in scope regarding work performed by an employee assigned to this position classification.  Management reserves the right to add, modify, change or rescind the work assignments of this position.  Management also reserves the right to make reasonable accommodations so that a qualified employee(s) can perform the essential functions of this role.