Senior Financial Health Care Data Analyst II

• Design, develop and implement standard plan or provider financial and operational reports in response to customer requirements and business needs

• Lead and implement internal controls; facilitate definition of data and other information requirements; define efficient data assembly methods; and maintain adequate documentation for general reference and audit purposes.

• Interpret data and develop reports to communicate findings to senior management.

• Participate in project workgroups; facilitate definition of project requirements and deliverables; influence the progress of team activities and the successful implementation of the project.

• Document and share project activities, analyses, and decisions.

• Develop, analyze, recommend, and enhance workflow processes related to project deliverables.

• Evaluates alternative solutions/decision in light of the potential impact on internal/external resources; understand the resource implications of solutions and makes other recommendations; communicate status and recommendations to management.

• Gather data post-implementation to measure outcomes and impacts.

• Develop, analyze, recommend, and monitor reimbursement and provider strategies; prepare reports that measure the effectiveness of reimbursement and contracting terms and the influence they may have on overall program/plan cost and utilization.

• Analyze data and identify trends, patterns, or other notable issues with an eye for cost reduction opportunities.

• Monitor market trends to identify emerging opportunities or risks in business environments.

• Monitor various websites for reimbursement and policy changes, focusing on Government entities; make recommendations for implementation of changes.

• Communicate with various stakeholders, including physicians, hospital admin staff, other healthcare insurers, auditors, and other departments within the company.

• Annual review of compliance workflows, such as, SSAE, MAR.

• Actively participate in current audits; be able to respond comprehensively to auditor inquiries.

• Review provider contracts and ensure that claims system set ups accurately reflect fully executed, signed agreements.

• Respond to ad-hoc data requests from management, executive staff, and external departments.

• Performs all other miscellaneous responsibilities and duties as assigned or directed

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