EMC Senior Analytic Specialist

Supports the Resource Stewardship Department and the External Medical Cost (EMC) Unit goals and accountabilities by providing analytic expertise which promotes understanding of external medical costs, cost drivers and opportunities for cost structure improvement. Accountable for creating a culture of compliance, ethics and integrity. Maintains knowledge of and assures departmental compliance with Kaiser Permanente's Principles of Responsibility and policies and procedures, and applicable regulatory requirements and accreditation standards. Responds appropriately to observed fraud or abuse.
Essential Functions:
Builds complex queries using SQL in one or more tools (e.g. Business Objects, SAS, SQL Assistant, Crystal) to extract data from mainframe and server-based data repositories based on client requests.
Analyzes data using SAS or Excel; draws conclusions and effectively articulates results to internal clients.
Applies quantitative and statistical analysis to develop clinical and utilization reports.
Demonstrates knowledge of KP data systems; actively shares knowledge within and outside the department.
Develops reporting processes and standard reports; financial/utilization models and forecasts to create utilization, quality and cost containment summary information to assist in decision support; leads and train teams on these processes.
Translates strategic plans into actionable decision support.
Coordinates data extraction, testing, and development of proposals for the annual operating forecast of professional, technical, other benefits and hospitalization expenses.
Makes decisions that involve complex problems requiring extensive research, analysis and evaluation of multiple variables.
Displays strong written and verbal communication and presentation stills; communicates effectively with all levels of leadership, staff and physicians.
Basic Qualifications:
Experience
Minimum six (6) years of experience performing sophisticated business analytics and report development.
Education
Bachelor's degree required.
License, Certification, Registration
N/A
Additional Requirements:
Demonstrated experience in leading and managing projects.
Demonstrated experience in data extraction, manipulation and/or data management, and interpreting and communicating results/recommendations.
Demonstrated customer service skills, customer focus abilities and the ability to understand Kaiser Permanente customer needs.
Candidate must demonstrate knowledge of key influences impacting the business and implications and demonstrate ability to communicate recommendations effectively with senior leaders in the organization.
Advanced PC proficiency with Microsoft Excel, Microsoft Word, Microsoft Access and graphics.
Highly proficient with health care claims data, SAS/graph, statistics for process improvement, Excel, Visual Basic for Applications, and/or principles for graphical presentation of quantitative data.
Preferred Qualifications:
Experience with predictive and descriptive data modeling, forecasting and data manipulation is preferred.
Bachelor's degree in business/health care administration, health services with the emphasis in finance, epidemiology, bio-statistics, industrial engineering or public health preferred.
Master's degree preferred.

Don't Be Fooled

The fraudster will send a check to the victim who has accepted a job. The check can be for multiple reasons such as signing bonus, supplies, etc. The victim will be instructed to deposit the check and use the money for any of these reasons and then instructed to send the remaining funds to the fraudster. The check will bounce and the victim is left responsible.

More Jobs

Senior Engagement Specialist
Englewood, CO AECOM Technology Corporation
Web Analytics Specialist
Englewood, CO Arrow Electronics
Senior Engineering Specialist
Englewood, CO Hughes Network Systems, LLC
Senior AR Specialist
Denver, CO Lucas Group - Search
Senior Systems Specialist
Denver, CO WSP