Analytics & Reporting Consultant

Analytics & Reporting Consultant

Requirements

• Bachelor degree and 4 years of analytical experience in relationship management or driving analytics insights into action OR 9 years of analytical experience in relationship management or driving analytics insights into action.
• Experience gathering and document business requirements in support of information-related strategies.
• Experience solving complex problems; Experience taking a new perspective using existing solutions.
• Knowledge of various software development processes, including SDLC, Agile methodologies, and tools and technologies.
• Experience creating and conducting presentations to inform and influence.
• Experience in leading functional teams and projects.
• Experience with SAS, SPSS, R, MATLAB, SQL, Python etc.
• Clear and concise verbal and written communication skills.
• PC proficiency with Microsoft applications including Access, Excel, Word and Power Point.

Responsibilities

• Evaluating financial impact of reimbursement changes associated with contract negotiations.
• Evaluating accuracy of provider contracts leveraging and/or creating reports, insights and analytics in support of the division.
• Understanding contract terms and how they translate into provider payment.
• Interfacing with provider negotiation team to discuss modeling impact or contract discrepancies.
• Creating specifications for modeling and/or contract audit process enhancements based on business needs.
• Possibly providing consultation to users and leading cross-functional teams to address enterprise/divisional contract or reimbursement issues.
• Producing datasets and reports for reimbursement analysis using system reporting tools.
• Possibly performing research and assisting in analyzing contracts and/or data related to enterprise/divisional strategic initiatives and broader research needs.
• Interfacing between the business and divisional data teams to generate tools to be leveraged in building analysis and reports which are actionable within the business environment.
• Working closely with customers to build relationships.
• Continuously gaining a deeper understanding of the division’s contracts and data in order to meet business needs.
• Analyzing complex business problems and issues using data from internal and external sources to provide insight to decision-makers.
• Identifying and interpreting trends and patterns in contracts and/or datasets to locate influences.
• Acting as the liaison between business and analytical teams.
• Communicating healthcare payer-based business concepts to analytics users.
• Communicating and marketing the value of analytics outputs to business users in healthcare payer settings.

Preferred Qualifications

• Understanding of healthcare provider reimbursement methods (e.g., DRG, OPPS, Case Rate, Per Diem, Stop Loss, RVU).
• Experience evaluating financial impact of reimbursement changes within healthcare provider contracts.
• Experience reviewing and evaluating healthcare provider contracts.
• Knowledge of medical coding process and conventions.
• Bachelor’s degree in business, engineering or mathematics.
• Master’s degree.
• Healthcare experience in contract audit, contract negotiation, business analytics, or innovation management.