Job Description

Location: Health Choice Management Co.
Posted Date: 11/17/2020

Position Purpose: This position develops and finalizes reporting required to proactively support medical management activities, provider contracting and management activities, financial and accounting activities, and other senior leaders of the company. The Healthcare Report Developer provides key information critical to decision making, leveraging advanced SQL development to deliver value to key stakeholders.

Responsibilities:

  • Performs requirement analysis, validation and verification, ensuring that requirement statements are complete, consistent, concise, comprehensible, traceable, feasible, unambiguous, and verifiably actionable.
  • Manages requirements traceability information and track requirements status throughout the project.
  • Participates in the peer review process to ensure all reports are reviewed before distribution.
  • Designs and develops reports and analyzes data to measure financial or clinical outcomes, network performance, care management, claims processing, operations and/or other areas of the business.
  • Develops medical cost reporting, including standardization of cost categories of service, unit cost and utilization metrics.
  • Assists in development of business requirements for decision support tools and reports.
  • Creates dashboards generated from trend data, utilization authorization, risk adjustment, and claims data to support departmental functions.
  • Models hospital, physician and ancillary contracts in order to advise network contractors during rate negotiations, as well as provide monthly analysis of overall network performance.
  • Works closely with Finance and other departments, as necessary, in order to determine business analytic and reporting needs, to clarify requirements and scope, and to identify and understand the business needs and purpose of the department or team.

Education / Experience / Other Requirements

Education:

  • Bachelor’s degree (B.S.), or equivalent, in Computer Information Systems, Computer Science, Information Technology, or Healthcare Administration obtained at a four-year college or university preferred, but not required

Years of Experience:

  • Minimum of one (1) to three (3) years of experience working with data, reporting, and analysis in a workplace setting
  • Experience working in a healthcare or managed care environment preferred

Specialized Knowledge:

  • Significant SQL and MS Excel skills are required
  • SSMS, SSRS, SSIS, Visual Studio
  • Business intelligence platforms (Qlik Sense, Qlik View, Tableau, Power BI)
  • Other programming languages (Python, R, etc.) are a plus
  • MS Word, MS Access, MS PowerPoint
  • Data Mining, preferably within a healthcare environment
  • Data analysis and insights
  • Statistical Analysis
  • Business and finance principles and practices
  • Utilization Methods
  • Normalizing Data
  • Requirement analysis and gathering
  • Development lifecycle
  • Documentation of project requirements, development, and status tracking in an IS environment
  • Software systems, preferably in a healthcare insurance environment

Skills & Abilities:

  • Excellent written and verbal communication
  • High level of critical thinking and problem solving
  • Ability to think analytically and make independent decisions
  • Ability to maintain a positive work environment
  • Ability to maintain positive work relationships
  • Ability to complete tasks with little supervision
  • Ability to manage large workload
  • Handle multiple and frequently changing priorities
  • Work cooperatively, positively, and collaboratively in an interdisciplinary team
  • Ability to manage multiple projects and prioritize work tasks to adhere to deadlines and identified time frames
  • Ability to translate business needs to technical specifications
  • Ability take the initiative and be innovative

Application Instructions

Please click on the link below to apply for this position. A new window will open and direct you to apply at our corporate careers page. We look forward to hearing from you!

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