This job will have the following responsibilities:
Serve as technical lead in analysis and reporting efforts that support the Health Plan’s Clinical and Provider teams, programs and quality activities.
Significant participation in analysis, interpretation, and translating of complex health plan data, issues, trends, and relationships into effective strategies and action plans.
Present findings of analyses to various staff levels including executive team, leadership team and staff levels. Present results in formats that are easy to understand and appropriate to the audience.
Use analytical skills to determine solutions and resolve problems.
Exercises timely and accurate data mining techniques and develops new or modifies existing reports that ensure consistent and congruent conclusions to data analysis.
Applies statistical modeling methodologies when appropriate in the development of health plan, provider, and member analysis.
Develops and prepares reports to support clinical and provider units utilizing available analytics and data mining tools, including but not limited to: Microsoft Applications (including MS Access), SAS, SPSS, Crystal Reports, system-specific reporting tools (e.g., MedHOK, CRM,) or other related reporting software.
Responsible for evaluating report requests to determine requestor’s needs and objectives, identifying correct methodology for extracting data including data sources and criteria, and ensuring the delivered report is accurate, timely, and formatted appropriately.
Responsible for understanding the various data sources available within for reporting and analysis, as well as a clear understanding of business operations to be able to appropriately guide the development of quality program activities, including analysis and reporting.
Responsible for managing assigned projects and effectively communicating with the QS leadership team any project deadlines that may be in jeopardy of being met, well in advance of the due date.
Document all analysis / reporting projects following established protocols, ensuring replication of results by an independent reviewer.
Designs and enhances databases to support reporting and analysis needs, including testing, validating, and maintaining data integrity and accuracy, across multiple databases
Demonstrate a commitment to incorporate LEAN principles into daily work.
Establish and maintain effective working relationships with others throughout the organization.
Any other duties as required to ensure the Health Plan operations are successful.
Ensure the privacy and security of PHI (Protected Health Information) as outlined in policies and procedures relating to HIPAA compliance.
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Job ID: 620076
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The Judge Group is a privately owned, leading professional services firm with nearly 50 years of experience in providing technology, talent, and learning solutions. Our services are successfully delivered through a network of more than 35 offices in the United States, Canada, and India. The Judge Group serves more than 47 Fortune 100 companies and is responsible for 7,000 professionals on assignment annually across a wide range of industries.