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Network Performance Analytics - Health Business Analyst

Company: Florida Blue
Location: Hialeah
Posted on: January 15, 2021

Job Description:

Health Business Analyst - Network Performance Analytics

The Health Business Analyst within the Commercial Network Performance Analytics team will provide analytical support for provider negotiations, assessing financial reimbursement models, and various provider network initiatives . Additionally, analytical support may be needed across other key functional areas of the organization including Actuarial, Payment Integrity, Product, and Segment requiring development of analytical approaches, conclusions and effective communication to various targeted audiences.

The ideal candidate will have strong critical thinking skills, experience working with large data sets, ability to draw inferences, an understanding of various provider reimbursement methodologies and a natural curiosity to understand health insurance informatics.

The Skills You Bring:

  • Analyze claims data in conjunction with provider reimbursement methods to determine financial impacts, cost drivers and improvement opportunities in support of provider negotiations. Outputs are also used for forecasting, planning, assessing risk and developing strategic considerations.
  • Monitor and evaluate patterns, costs and trends as they relate to the delivery of health care services for all ancillary provider types including urgent care centers, labs, skilled nursing centers, and dialysis centers.
  • Produce basic spreadsheets, documents and presentations that are well-documented and easy to follow (e.g., Excel, PowerPoint, and Tableau).
  • Modify existing programs and write basic SAS/SQL programs for data extraction.
  • Proactively seeks training and builds knowledge/experience of technical tools, coding languages and data sources.
  • Ability to work in team environment emphasizing collaboration and the development of synergies.
    Required Skills:
    • 2+ years related analytical work experience with a focus in the health or medical industry or equivalent combination of transferable experience and education
    • Master's degree in relevant field can be substituted for work experience requirement
    • Bachelor's degree required
    • Experience with analytics and demonstrated clinical thinking skills
    • Experience writing SQL/SAS code or related code

      Preferred Skills:
      • Bachelor's degree in Business Analytics, Statistics, Data Science, Health Economics or similar program
      • Master's degree in a related field
      • Working knowledge of various provider reimbursement methodologies
      • General knowledge and experience in the healthcare industry

        We are an Equal Opportunity Employer/Protected Veteran/Disabled. Associated topics: analyze, bi, business intelligence, business systems analyst, financial analytic, government, investment analytics, legal, strategy, valuation analyst

Keywords: Florida Blue, Hialeah , Network Performance Analytics - Health Business Analyst, Healthcare , Hialeah, Florida

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