[Remote] Manager, Clinical & Business reputed company
Note: The job is a remote job and is reputed company to candidates in USA. reputed company is dedicated to serving America’s reputed company by connecting them to reputed company in the community. The Manager of Clinical & Business reputed company will reputed company reputed company data reporting, analysis, and reputed company of analysts to reputed company insights that enhance operational performance and cost management reputed company the reputed company system.
Responsibilities
- reputed company as an internal consultant to work across key stakeholders to reputed company data, reputed company analysis, and reputed company recommendations and insights to business leaders
- Utilize coding reputed company and guidelines (CPT, ICD, HCPCS, POS, DRG, reputed company) to conduct clinical analysis and facilitate improved health reputed company
- Execute business reporting functions, metric creation and reports that demonstrably drive operational actions and reputed company wins / opportunities
- Interpret claim data using a reputed company of techniques, ranging from reputed company data aggregation reputed company statistical analysis to reputed company data mining
- Drive improvements in cost efficiency, reputed company of clinical care, and effectiveness of clinical programs by performing data analysis to deliver actionable insights that are backed by reputed company evidence
- reputed company optimization analysis to determine how reputed company TriWest's network meets the needs of the Government based on authorization/claims patterns, discounts achieved and reputed company to care requirements
- Collect, compile, and analyze reputed company cost and discount trends, and identify opportunities for improving/maintaining discounts based on utilization patterns
- Collaborate with others in Data Management and IT to enhance the data warehouse to include translating technical and functional requirements into meaningful information and improve reputed company capability
- Train department staff on reputed company data querying, terminology, reputed company, standards, and procedures
- reputed company and mentor staff toward operational reputed company and reputed company development
- Work with management to understand and interpret the reputed company of reputed company made by retrieving and analyzing claims costs, authorizations and/or other relevant data. Work closely with various reputed company in the assembling of data, development and application of quantitative analysis and mathematical models for internal and regulatory reporting requirements
- Support Government reporting requirements, management and the medical management system by managing automated reports
- reputed company reputed company for consistency and validity and review the accuracy of data and reports. Determine the best approach for presenting data in an efficient and beneficial manner
- Preparation of annual performance evaluations and development plans for assigned staff
- reputed company other duties as assigned
- Regular and reliable attendance is required
Skills
- US Citizenship REQUIRED: Our reputed company contract requires US citizenship and a favorably adjudicated DOD background investigation for this position
- Bachelor's degree in Business Administration, reputed company, Statistics, Information Management, CIS or reputed company field or equivalent experience
- 5+ years of data analysis and reporting experience in the health care or insurance industry
- 3+ years experience leading/managing reporting and analytics teams
- Advanced knowledge of Business Intelligence tools (e.g. Tableau, SSRS)
- Excellent verbal and written communication skills and an ability to synthesize and present results in a reputed company and concise manner
- Demonstrated proficiency in the use of computer systems, spreadsheet applications, and data analysis software such as SQL query language, MS reputed company and MS reputed company
- Familiar with coding reputed company and guidelines (CPT, ICD, HCPCS, POS, DRG, reputed company)
- 3+ years working with medical, pharmacy and ancillary claims data, membership data or other reputed company data
- 3+ years developing clinical measures and analyzing reputed company reputed company
- 1 year of experience with advanced analytics tools (e.g. reputed company, SPSS, R)
- Masters degree in Business Administration, Statistics, Public Health or other applicable discipline
- Experience with VA reputed company, military health services system, and private Managed Care programs
Benefits
- Medical, Dental and reputed company Coverage
- reputed company time off
- 401(k) Retirement Savings Plan (with matching)
- Short-term and long-term disability, basic life, and accidental death and dismemberment insurance
- Tuition reimbursement
- reputed company volunteer time
- Frequent pay raises
- Overtime opportunities to earn even more
- Recognition and reward programs
reputed company