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Job Profile Summary
Thisindividualwillberesponsibleforanalyzingcomplexclinicaland financial(claims-based)scenariostosupportinformed decision making.This person worksrelatively independentlywith limited direction and supervision. Responsible for gathering and interpreting claims clinical and administrative data to build effective financial models make reasonable assumptions and reachappropriate conclusions. Serves as a resource and consultant across the system and sites to design and produce relevant information to inform strategies essential to the success of population healthinitiatives.
Job Description
Major Responsibilities:
Prepares analyses and develops routine and special management reports and reporting tools to support ongoing PHOCINRBO operations finance care management clinical risk adjustment and department management decision making. Works with administrative and physician leadership (site and system).
Analyzethetotal cost of care and payer contract performance using any and all data systems available.Makes specific recommendations to management and physician leadership (site and system) based on the results of these analyses. Analyze clinical financialand quality performance by site physician and contract. Proactivelyidentifyareas for analysesandshare information with physician and administrative leadership.
Conduct and present analyses that drive improved delivery of value-based care.
Works with IT partners to diagnose correct andvalidateany issues with the data populating business intelligence tools.
Creates efficient presentations of quantitative and qualitative information by minimizing text and appropriately incorporating visual displays. For executive level reports craft a concise written summary of key report conclusions and clearly translate analyses and visualizations into practical and actionable recommendations. Summarizes analytical findings in ways that business leaders and front-line clinicians can quickly understand and use to drive performance improvement.
Assumes responsibility formaintainingcurrent knowledge of government regulations policies and trends that affect the health care industry and independently conduct online research to access documents pertinent regulations or to access publicly available datasets.
Licensure Registration and/or Certification Required:
None Required.
Education Required:
Bachelors Degree in Accountingor related field or
Bachelors Degree in Business or
Bachelors Degree in Health Care Administration or
Bachelors Degree in Computer Science.
Experience Required:
Typically requires 5 years of experience inclinicaldataanalysisor analytics experience in health insurance or healthcare fields.
Knowledge Skills & Abilities Required:
Must have strong analytical skills advanced Microsoft Office Suite skills specifically in Excel and PowerPoint and be able to communicate effectively with management and staff at all levels.
Advanced analytical skills includingtheability to analyze quantitative and qualitative data and reach sound conclusions.
Advanced computer skills including Microsoft OfficeSuite;especially Excel.
Experience with one or more business intelligence tools (e.g.PowerBI Business Objects Strata).
Good communicationskills including verbal communication and business writing.
Working knowledge inthehealthcare insurance industry healthcare finances care management clinical risk adjustment and/or physician practices.
Good project management and time management skills.
Good interpersonal skills includingtheability to communicate at all levels within the organization.
Experience withEMRs (Electronic MedicalRecords)preferred.
Experienceandability to createcomplexqueriesin SQL or other query languages.
Ability tocode in Pythonpreferred.
Physical Requirements and Working Conditions:
Position may require some travel. May be exposed to road and weather hazards.
Generally exposed tonormaloffice environment.
Operates all equipment necessary to perform the job.
This job descriptionindicatesthe general nature and level of work expected of the incumbent. It is not designed to cover orcontaina comprehensive listing of activities duties or responsibilities requiredofthe incumbent.Theincumbentmaybe requiredto perform other related duties.
Pay Range
$0.00 - $61.65Staff Exempt (CHESS)Our CommitmenttoYou:
Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs competitive compensation generous retirement offerings programs that invest in your career development and so much more so you can live fully at and away from work including:
Compensation
Benefits and more
About Advocate Health
Advocate Health is the third-largest nonprofit integrated health system in the United States created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas Georgia and Alabama; and Aurora Health Care in Wisconsin Advocate Health is a national leader in clinical innovation health outcomes consumer experience and value-based care. Headquartered in Charlotte North Carolina Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology neurosciences oncology pediatrics and rehabilitation as well as organ transplants burn treatments and specialized musculoskeletal programs. Advocate Health employs 155000 teammates across 69 hospitals and over 1000 care locations and offers one of the nations largest graduate medical education programs with over 2000 residents and fellows across more than 200 programs. Committed to providing equitable care for all Advocate Health provides more than $6 billion in annual community benefits.
Required Experience:
IC
Proudly serving Wisconsin with 18 hospitals, over 150 clinics and 70 pharmacies across 30 communities. Choose Aurora Health Care for you and your family.