Description and Requirements
The Healthcare Analyst will support the Provider Risk Analytics team in monitoring provider financial performance and responding to varied requests from internal and external stakeholders requiring analysis of member, provider, and claims data. The ideal candidate is a team player, detail-oriented and has an interest in a role at the intersection of Healthcare, Finance, and Data Analysis. ~Hybrid Work Schedule consists of reporting to our 100 Church Street, NYC office 3 days per week~
Duties/Responsibilities:
- Monitor costs and revenue trends for Provider Organizations.
- Work cross-departmentally to determine provider performance results, package data into key points and visuals, and communicate to internal leadership and external stakeholders.
- Support contract analytics and fee schedule modeling to aid in contract negotiations and budget development.
- Respond to ad-hoc requests, including, but not limited to, claims reports, membership shifts, and impact of operational changes.
- Maintain awareness of industry changes, including updates issued by New York related to Medicaid and CMS related to Medicare.
- Bachelor's degree or higher from an accredited institution with a concentration in Finance, Business, Public Health or Healthcare Administration.
- Self-motivated, creative problem solver who can work independently and collaborate through strong communication and interpersonal skills.
- Familiarity with healthcare, medical cost and utilization trends.
- Experience with MS Excel (lookups, sum product, array formulas).
- Knowledge of SQL, Medicaid/Medicare programs, Healthcare Claims and/or reimbursement preferred.
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Minimum Qualifications:
- Bachelor's degree or higher from an accredited institution with a concentration in Finance, Business, Public Health or Healthcare Administration.
- Self-motivated, creative problem solver who can work independently and collaborate through strong communication and interpersonal skills.
- Familiarity with healthcare, medical cost and utilization trends.
- Experience with MS Excel (lookups, sum product, array formulas).
- Knowledge of SQL, Medicaid/Medicare programs, Healthcare Claims and/or reimbursement preferred.
Preferred Qualifications:
- Understanding of key managed care concepts and provider reimbursement principles such as risk adjustment, capitation, FFS (Fee-for-Service), Diagnosis Related Groups (DRG's), Ambulatory Patient Groups (APG's), Ambulatory Payment Classifications (APC's), and other payment mechanisms.
- Knowledge of Medicaid, Medicare programs and Healthcare industry
Hiring Range:
- Greater New York City Area (NY, NJ, CT residents): $67,200 - $97,155
- All Other Locations (within approved locations): $59,800 - $88,910
As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision.
In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live.
The hiring range is defined as the lowest and highest salaries that Healthfirst in "good faith" would pay to a new hire, or for a job promotion, or transfer into this role.
WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, gender identity, sexual orientation, national origin, age, genetic information, military or veteran status, marital status, mental or physical disability or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.