Assists the Director, Strategic Analytics in a client-facing position accountable for managing client expectations while delivering the services and solutions associated with our analytical offerings. Acts in a consultative capacity to assist clients in addressing outstanding financial or clinical information needs. Quickly understands and interprets data, how it can be applied, and its limitations to ensure analytic projects are scoped correctly and that expectations are met. Manages and participates on project teams to provide direction and insight on the use of sophisticated quantitative studies using both billing data and claims based data, as well as other data sources when necessary, in order to advance operational performance based on quality, utilization, cost and other key drivers. Develops best in class analytic solutions that solve complex business problems.
Analytics and Strategy
· Leads system wide modeling work for commercial fee for servicecontracts including narrow networks, new products, and physician fee for service analysis
· Leads modeling support for commercial accountable care organization (ACO) contract negotiations
· Ongoing monthly and quarterly performance reporting including ACO contract target setting, completion factors, trends and PMPMs
· Performs Risk Score calculations and monitoring
· Responsible for analytics relationship with third party benefits administrator and Human Resources
· Provides consultation/advice on issues with existing analytics and data solutions
· Designs and scopes analytical projects; formulates methodology, establishes data requirements, identifies client deliverables, determines tasks and timing
· Executes complicated analyses and makes the results accessible and relevant to business users
· Develops and refines analysis templates for problem diagnosis and opportunities assessment
· Designs and supports analytic solutions that will help the organization in care redesign, clinical delivery and operations, and performance reporting
· Completes special projects and management reports as assigned
Fosters the training and development of the necessary skills and knowledge for staff members
· Uses effective strategies to facilitate organizational change initiatives and overcome resistance to change.
· Develops long-term objectives and strategies; translates vision into realistic business strategies.
· Oversees the day-today management of the operations, establishment of work schedules, review of staffing needs and the supervision and training of staff including succession planning for the Analytics Consulting and Advanced Analytics teams
· Participates in establishing and preparing departmental plans, three year roadmaps, goals, standards, procedures, and instructions, which contribute to the effectiveness of the department in accordance with organizational goals
Basic UPH Performance Criteria
· Demonstrates the UnityPoint Health Values and Standards of Behaviors as well as adheres to policies and procedures and safety guidelines.
· Demonstrates ability to meet business needs of department with regular, reliable attendance.
· Employee maintains current licenses and/or certifications required for the position.
· Practices and reflects knowledge of HIPAA, TJC, DNV, OSHA and other federal/state regulatory agencies guiding healthcare.
· Completes all annual education and competency requirements within the calendar year.
· Is knowledgeable of hospital and department compliance requirements for federally funded healthcare programs (e.g. Medicare and Medicaid) regarding fraud, waste and abuse. Brings any questions or concerns regarding compliance to the immediate attention of hospital administrative staff. Takes appropriate action on concerns reported by department staff related to compliance.
Associate of Society of Actuaries required (ASA)
· Bachelor’s degree in Accounting, Actuarial Science, Business, Economics, Finance, Healthcare Administration, Statistics or related field required
· Equivalent experience is five years in a healthcare operations or healthcare analytics setting
· Fellowship of Society of Actuaries (FSA) desired
· Five years of experience in analytics in an actuarial, finance, statistical or underwriting setting.
· Advanced actuarial modeling experience is required.
· Three years managerial experience is highly desired.
Valid driver’s license when driving any vehicle for work-related reasons.
· Strong communication skills- able to blend technical skills, analytical expertise and business acumen.
· Requires highly developed communications and negotiation skills to effectively work with all levels of management throughout UnityPoint Health, its subsidiaries and affiliates.
· Possesses excellent writing and verbal communications skills and the ability to understand and communicate concepts to technical and non-technical individuals.
· Demonstrates an ability to coordinate and manage large, complex projects and be able to negotiate and build consensus among groups or individuals with diverse interests and function effectively as a team leader in a team environment.
· Requires a general knowledge of business and management principles.
· Ability to understand and deal effectively with problems and opportunities, which arise, in a complex multiprocessing environment are crucial.
· Knowledge of regulatory and accreditation requirements is mandatory.
· Ability to work as a team member, creating and maintaining effective working relationships.
· Ability to understand and apply guidelines, policies and procedures
· Knowledge of provider payment/network, ACO and managed care concepts is desired.
· Demonstrates knowledge of healthcare industry systems is highly desired
Use of usual and customary equipment used to perform essential functions of the position.