Analytics
Health care Analyst
Pune, Maharashtra, India

 

Job title

Healthcare Analyst

Department

NCH EDWBI

Report To

NA

Work Location

Pune

 

It’s Time For A Change…

Your Future Evolves Here

Evolent Health has a bold mission to change the health of the nation by changing the way health care is delivered. Our pursuit of this mission is the driving force that brings us to work each day. We believe in embracing new ideas, challenging ourselves and failing forward. We respect and celebrate individual talents and team wins. We have fun while working hard and Evolenteers often make a difference in everything from scrubs to jeans.

Are we growing? Absolutely about 40% in year-over-year revenue growth in 2018. Are we recognized? Definitely. We have been named one of “Becker’s 150 Great Places to Work in Healthcare” in 2016, 2017, 2018 and 2019, and One of the “50 Great Places to Work” in 2017 by Washingtonian. If you’re looking for a place where your work can be personally and professionally rewarding, don’t just join a company with a mission. Join a mission with a company behind it.

 

Position summary



The Healthcare Analyst provides clinical and financial analysis and reporting for the company’s existing clients and provides support for pricing new business.

 

Essential functions

 

  • 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.

 

Key competencies/skill/success factors:

 

  • Work experience with line item healthcare claims and PBM information is preferred.
  • Must have extensive knowledge of and experience with SQL
  • 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.
  • Experience with business Intelligence tools such as
  • 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
  • Formal training in  statistical or  data science is required. 

 

Qualification and Experience:

Required

  • At least a Bachelor's degree with emphasis in Economics, Computer Science, Statistics, Math or Business, or equivalent work experience.
  • Minimum of 2-4 years’ work experience in an analytical role.
  • Master degree in a quantitative field preferred.
  • Formal training in  statistical or  data science is required. 

Big plus

NA

 

Work Environment:     

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. This position primarily works in a climate controlled based setting.The noise level and the work environment are moderately quiet. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines

 

Physical demand:

Include the physical demands of the job, including bending, sitting, lifting and driving.  For example, while performing the duties of this job, the employee is regularly required to talk or hear.  The employee frequently is required to stand; walk; use hands to finger, handle or feel; and reach with hands and arms.  

Why Join Evolent?

Evolent Health developed an integrated value-based care platform for payers and providers. The company created an internal recognition program that encourages departments to acknowledge outstanding achievement as well as focusing on philanthropic values. The company spent four weeks in 2018 giving back to more than 60 local charities and engaged 3,700-plus employees to participate. Evolent provides healthy snacks and drinks in most of its offices as well as an in-office gym at its headquarters and workstations that include treadmill desks. In 2016, the company launched its diversity and inclusion committee that promotes unconscious bias training and established several business resource groups. In 2017, Washingtonian Magazine named Evolent among the 50 Great Places to Work.


 

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