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DATE ADDED: Fri 01/11/2019

Provider Performance Analyst

Lansdowne, PA, US
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COMPANY: AMERIHEALTH

JOB TYPE: Permanent, FullTime

Job Brief

Develops and implements data-driven solutions to meet business requirements by producing analytics, reports and data sets

Your career starts now. We’re looking for the next generation of health care leaders.

At AmeriHealth Caritas, we’re passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we’d like to hear from you.

Headquartered in Philadelphia, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at #removed#.

Responsibilities:

  • Develops and implements data-driven solutions to meet business requirements by producing analytics, reports and data sets across a variety of subject matters – primarily related to, but not limited to, value-based contracting, medical and quality management, population health, network management, contracting, marketing and member outreach, and new business initiatives.
  • Audit data to ensure the maximum level of accuracy, integrity, consistency, and completeness in the various internal/external data sources and in report submissions.
  • Responsible for development, maintenance and settlement of provider incentive models throughout the AmeriHealth Caritas Family of Companies.
  • Generates and maintains thorough and accurate documentation related to data, databases, value-based contracting models, business rules, and reporting policies and procedures for all LOBs.
  • Identifies data-related issues, and conducts root cause analyses; facilitates resolution of    known issues by working directly with end-users and IT staff. 
  • Establishes business rules for accurate use of reporting data fields. 
  • Identifies new and maintains existing sources of data to ensure the availability of information for reporting purposes. 
  • Develops and executes test processes related to end-user data and databases; documents and tracks data-related issues, and facilitates resolution of such issues. 
  • Supports identification of training opportunities as they relate to data comprehension and reporting; assists with creation of new models and metrics to track provider performance.

Education/Experience:

  • Bachelors’ degree required in relevant field.
  • Minimum of 3+ years of Data Analysis, Reporting, Claims, Managed Care or Healthcare experience required.
  • Extensive knowledge of Microsoft Office products is required.
  • Demonstrated skills with at least one reporting application such as:  SAS Enterprise Guide,  SQL and/or MS Access. 
  • Experience developing value based programs is preferred.
  • Preferred project management experience including overseeing different initiatives and the coordination and completion of projects on time and within scope.

Note:  Our current location is 200 Stevens Drive, Philadelphia, PA 19113. We are in the process of building a new headquarters in Newtown Square. That address is 3805 West Chester Pike, Newtown Square, 19073. This role/department will be transitioning there at the end of 2020. 

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