Financial Analytics Lead Contracting Strategy

Profile

Description

The Financial Analytics Lead manages data to support and influence decisions on day-to-day operations, strategic planning and specific business performance issues. The Financial Analytics Lead works on problems of diverse scope and complexity ranging from moderate to substantial.

Responsibilities

The Financial Analytics Lead collates, models, interprets and analyzes data in order to identify, explain, influence variances and trends. Explains variances and trends and enhances modeling techniques. May possess financial or actuarial background. Advises executives to develop functional strategies (often segment specific) on matters of significance. Exercises independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision, Uses independent judgment requiring analysis of variable factors and determining the best course of action.

Key Responsibilities

Utilize multiple data sources, maintain customer relationships and create advanced analytics to facilitate contracting initiatives and support our National hospital and ancillary contractors.

Function as a point-of-contact for all Ancillary provider contracting initiatives' analytics including Home Health, Skilled Nursing Facilities, Dialysis, Lab and Durable Medical Equipment.

Will use a consultative approach to collaborate effectively with the markets, and other customers.

Act as a key resource and liaison to other functional areas of Humana's business, building productive cross-functional relationships.

Design and construct models to estimate impact of contractual changes tied to ancillary and industry leading innovative care delivery models

Extract historical data, perform data mining, develop insights to drive provider contracting strategy and reimbursement terms

Evaluate reimbursement methods and models in light of changes from CMS or internal contracting strategies, leverage insights to recommend and deploy new initiatives.

Develop tools and automate processes to model financial implications of ancillary contracted rate changes, including changes in capitated arrangements

Ability to lead projects and manage 1-2 associates

Required Qualifications

Bachelor's Degree in analytics or related field

5 or more years of demonstrated healthcare analytical experience

Experience with stakeholder identification, relationship building, and working across the organization on matters of significance to senior leadership

Advanced experience working with big and complex data sets within large organizations

5 years of SQL experience

Experience presenting complex concepts to senior leadership

Must be passionate about contributing to an organization focused on continuously improving infrastructure, capabilities, and customer experiences

Preferred Qualifications

Advanced Degree

Previous management experience

SAS, Python, R, and/or other languages

Diverse experience, including understanding of healthcare membership, claims, and other data sources used to evaluate cost, use, price, mix, risk adjustment, and other key financial and quality metrics

Scheduled Weekly Hours

40

Company info

Humana Inc.
Website : http://www.humana.com