Senior Director, Business Analytics


Company JobLeads
Reference 462058903
Sector Consultancy/Strategy
Town/City USA
Locations USA
Job Type Permanent
Date Posted 30th Jun

Shortlist Apply

Job Description


* Provide vision, strategy and operational leadership for the company's health economics functions relating to business development, financial outcomes and contracting analysis. Serve as primary corporate analytical contact for the company to support Centene's and the Health Plans' information needs to support strategic and operational goals and objectives. * Support to all lines of business (Medicare/Medicaid/Exchanges/ASO/Hybrid), corporate departments, specialty companies, and state agencies in reviewing all costs * Manage inpatient estimation process for all health plans to price out all stays for use in month-end close process * Manage revenue reconciliation process including verifying correct payments from the state, correct eligibility setup in the system, and correct claims payments * Provide internal consulting for financial, IT, RFPs, rate setting and operational processes * Monitor and correct data quality and data processes throughout the organization * Provide utilization and cost analyses to support health plan and corporate health benefits ratio, utilizing enterprise analytic and predictive models and data analysis tools. * Create an analytical environment that enhances medical cost decisions to maximize utilization of these tools. Support the business process and systems to ensure integrity of the health economics/data warehouse data. * Direct the consolidation of health information to support medical expenditure and utilization analyses and evaluate new tools/models to support business * Identify risks and opportunities associated with future profitability and member retention * Support merger and acquisition opportunities with financial and statistical analysis * Conduct medical cost data economic analysis, research and development projects for the Health Plan's and Finance to identify strategic and operational opportunities, using enterprise tools * Prepare and distribute medical cost lags and month-end close reporting to finance, utilizing enterprise tools, * Help identify and understand data from internal and external sources for competitive, scenario and performance analyses, and financial modeling to gain member/provider insight into new and existing processes and business opportunities. * Direct the consolidation, organization, and manipulation of health information to support medical expenditure and utilization analyses and evaluate new tools/develop new models to analytically support existing and future business * Act as liaison/analyst manager for internal stakeholders, understand their needs and translate them into reporting and analytic solutions. * Analyze issues using enrollment, utilization, clinical, medical management, financial and other corporate data, and information from both modeled internal data as well as disparate internal and external sources. Also help staff develop better analysis skills, understanding use cases and their value to the organization. * Work with departmental staff to identify requirements for reporting and / or business intelligence tools. * Leverage advanced statistical analysis methods to create insightful recommendations and conclusions that you effectively communicate to your stakeholders. * Identify and address expected and unforeseen data complexities to mitigate their impact on the analytic outcome and associated business decisions. Clearly communicate data issues to the recipients and work to improve data quality where possible within the analytical models you create. Feed data quality issues back to IT or identified data stewards to assist in our quest for high quality data. * Adhere to corporate standards for performance metrics, data collection, data integrity, query design, and reporting format to ensure high quality, meaningful analytic output. * Work closely with IT on the ongoing improvement of Centene's integrated data warehouse, driven by strategic and business needs, and designed to ensure data and reporting consistency throughout the organization. * Prepare clear, well-organized project-specific documentation, including, at a minimum, analytic methods used, key decision points and caveats, with sufficient detail to support comprehension and replication. Delegating or providing direction and feedback to staff when appropriate. * Share development and process knowledge with analysts in order to assure consistency and continuously build a core of analytical strength within the organization. * Licenses/Certifications: MBA, CPA preferred * Bachelor's degree in Finance, Economics, Statistics, Health Administration or related field. * 8+ years of healthcare reporting and analytics. * Leadership experience and skills required. * Knowledge of data systems, IT processes, and reporting tools including SQL, Teradata, Microstrategy required. * Experience with accounting practices, state reporting requirements, and rate setting activities preferred., * Master's Degree in, Business, Mathematics or Health Science
 

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