Manager Decision Support Analytics- Medicaid Pharmacy & Finance Reporting

JOB SUMMARY

***CANDIDATE MUST BEUS Citizen (due to contractual/access requirements)***

This job oversees all daily operations and functions of the department. The incumbent requires an in-depth knowledge of business systems data warehousing data collection and reporting. The incumbentwill be tasked with ensuring all summary and analysis reporting projects are mechanically statistically and theoretically accurate. Additionally the incumbentwill be responsible for summarizing and presenting the results to enhance the organizations understanding of underlying trends results and implications. Organizes assigns and actively manages to completion the data analysis projects within the department.

ESSENTIAL RESPONSIBILITIES

• Performs management responsibilities to include but not limited to: involved in hiring and termination decisions coaching and development rewards and recognition performance management and staff productivity.
• Plan organize staff directand controlthe day-to-day operations of the department.
• Developand implementpolicies and programs as necessary.
• May have budgetary responsibility and authority.
• Serveas the decision support analytics subject matter expert in the development and implementation of dashboards and reports to support key clinical and operational initiatives.
• Maintainkey relationships with leadership and other stakeholders to proactively identify and communicate performance and continuous improvement opportunities for quality improvement and clinical effectiveness.
• Overseethe ongoing sourcing assessment defining and maintenance of business data to ensure integrity quality validity and overall applicability to the identification analysis and interpretation of ongoing trends or patterns in complex data sets for specified projects.
• Provideguidance on opportunities to enhance analytic capabilities with a particular focus on the ability to measure benchmark and track value metrics.
• Leadthe design implementation and maintenance of analytical processes and reports supporting Gateway Health Plans performance (internal to the organization and in comparison to industry benchmarks/best practices).
• Managethe utilization of measurement tools statistical methods and benchmark comparisons to determine and analyze outcome measures in support of organizational goals.
• Partnerwith leadership and process owners to define key metrics and analytic needs for implementation including dashboards scorecards and overall reporting solutions.
• Implementspecial initiatives to support the reporting and analytics needs of the organization as directed.
• Other duties as assigned or requested.

EDUCATION

Minimum

• Bachelors Degree in Clinical-related field Business Administration Healthcare Administration Health Information Management or related discipline or relevant experience and/or education as determined by the company in lieu of bachelors degree

Preferred

• Bachelors Degree - Clinical-related field Business Administration Healthcare Administration Health Information Management or related field

EXPERIENCE

Minimum

• 5 yearsof progressive experience in a clinical or reporting and analysis field in a healthcare organization
• Prior leadership and/or project management experience

Preferred

• Experience in a clinical area/function/organization

LICENSES & CERTIFICATIONS

Minimum

• None

Preferred

• None

SKILLS

• Advanced knowledge of SAS and SQL required
• Advanced computer skills with a strong knowledge of spreadsheet programs required
• Ability to perform under stressful and changing circumstances and deadlines; effective written and oral communication skills; and strong problem solving project management teamwork and organizational skills required
• The ability to assist in ensuring compliance with regulatory agencies and HIPAA regulations required

LANGUAGE REQUIREMENT (other than English)
None

TRAVEL REQUIREMENT:
0% - 25%

PHYSICAL MENTAL DEMANDS AND WORKING CONDITIONS

Position Type:

Office-Based

Office-Based Positions

An employee in this position works in an office environment. The position frequently requires the employee to communicate effectively with others both inside and outside the workplace (e.g. in person via telephone via email). The employee must be able to understand interpret and analyze data solve problems concentrate and research use available technological resources and systems (e.g. computers and computer programs) multi-task prioritize and meet multiple deadlines to complete essential tasks. The employee generally works in a fast-paced and frequently stressful environment must attend work on a regular and reliable basis as well as adhere to all workplace policies and may be called upon to work outside regular business hours.

Teaches/Trains others regularly

Frequently

Travels regularly from the office to various work sites or from site-to-site

Does Not Apply

Works primarily out-of-the office selling products/services (Sales employees)

Does Not Apply

Physical Work Site Required

Yes

Lifting: up to 10 pounds

Does Not Apply

Lifting: 10 to 25 pounds

Does Not Apply

Lifting: 25 to 50 pounds

Does Not Apply

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties responsibilities and qualifications required of employees to do this job.

Compliance Requirement: This position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities employees may have access to covered information cardholder data or other confidential customer information that must be protected at all connection with this all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Companys Handbook of Privacy Policies and Practices and Information Security Policy. Furthermore it is every employees responsibility to comply with the companys Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws rules and regulations as well as company policies and training requirements.

Pay Range Minimum:

Pay Range Maximum:

Base pay is determined by a variety of factors including a candidates qualifications experience and expected contributions as well as internal peer equity market and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal state or local law.

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