New Century Health is leading transformative change in specialty care management. By combining medical management expertise with a deep understanding of healthcare informatics, physician management and healthcare technology systems development, we generate insights that drive leading edge and effective innovation. What does this mean to you? It means that when you join us, you will be a key contributor to one the fastest growing healthcare services in the National Oncology and Cardiology care management space today. With your knowledge, skills and abilities, you will impact the delivery of care and directly contribute to our ability to positively impact and meet the critical unmet needs of patients suffering from all types of cancer.
We support our employees with an outstanding benefit package that features programs like employee paid medical benefits, 100% match on your 401k contribution up to 4% of your base salary, generous tuition reimbursement, as well as above average paid time off. If you are interested in working with some of the most dedicated, passionate and smartest people on the planet, express your interest in speaking with us and we will respond immediately
The Healthcare Analyst provides clinical and financial analysis and reporting for the company’s existing clients and provides support for pricing new business.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
- Acts with honor and integrity, serving as a role model for the company.
- Analyzes prospective and current client utilization data to identify utilization trends, calculate cost of healthcare and identify opportunities for New Century Health to add value to customers.
- Works with internal business customers to define report and dashboard requirements for use in managing day to day operations more efficiently.
- Assists with the QC/Validation of the data currently being developed into the data warehouse.
- Validates the completeness of potential client data files using various techniques.
- Extracts and compiles both internal and external data elements used in all aspects of the business from client pricing, medical cost management, operational reporting and general financial analysis as required.
- Populates existing pricing model with potential client information and makes suggestions on potential improvements to the model or corresponding presentation/reporting.
- Participates in or conducts presentations to prospective clients regarding New Century Health’s pricing methodologies.
- Reconciles capitation payments to eligibility data to ensure monthly payments received are accurate.
- Calculates and analyzes monthly capitation payments made to network providers; identifies and investigates unusual fluctuations and determines root cause of potential problems.
- Conducts recurring and ad hoc provider utilization analyses; prepares meaningful, professional reports for health plans.
- Respects and maintains HIPAA confidentiality guidelines.
- Acts as an interdepartmental liaison between all New Century Health offices, departments, and committees.
- Performs other duties as assigned.
EDUCATION and/or EXPERIENCE:
- At least a Bachelor's degree with emphasis in Economics, Computer Science, Statistics, Math or Business, or equivalent work experience.
- Master degree in a quantitative field preferred.
- Work experience with line item healthcare claims and PBM information is preferred.
OTHER SKILLS and ABILITIES:
- An understanding of CPT, ICD-9, Revenue and DRG codes is preferred.
- Must have expensive experience and proficiency leveraging SQL, including loading data, writing update and select statements, and joining tables.
- Experience with Excel spreadsheets and other office productivity applications to share and present analytic results.
- Experience with statistical analysis tools such as SAS Office Analytics.
- Experience with business Intelligence tools such as SAS Visual Analytics.
- Ability to understand and work with a variety of data formats to create charts, graphs, tables, and other visual means of representing key aspects of the data.
- Strong written and verbal communications, including the ability to summarize the results of data analysis for technical and non-technical audiences. Must also be comfortable presenting this information via in person meetings as well as webinar technologies.
- Experience with technical writing preferred.
- Must have strong analytical skills with the ability to develop advanced analytic models (e.g. forecasting).
- Must be skilled at prioritizing assignments and working to ensure all mission critical timeframes and deadlines are met.
- Must be able to work independently and demonstrate initiative and problem solving skills working within a fast paced start up environment.