Job Summary:

The Healthcare Analyst III is responsible for trend analysis, presenting analytical findings and recommendations regarding utilization to management and being proficient in identifying and quantifying opportunities to reduce medical costs while supporting high quality care for members.

Essential Functions:

• Analyze membership, provider, and claims data to uncover trends, variance opportunities, and performance drivers that impact health plan performance.
• Translate complex healthcare data into compelling, audience-specific stories that support/recommend decision-making
• Present analytical findings and recommendations to management
• Identify and quantify opportunities to reduce medical costs
• Use and enhance analytic methods to efficiently compare performance across and within markets and products
• Quickly and efficiently execute ad-hoc analytics requests from departments across the organization
• Perform any other job duties as requested

Education and Experience:

• Bachelor’s Degree or equivalent years of relevant work experience is required
• Advanced degree is preferred
• Minimum of five (5) years of experience in healthcare analytics is required
• Managed care experience is required

Competencies, Knowledge and Skills:

• Ability to organize data in a way that facilitates inferences, conclusions and decisions
• Demonstrated strong written and verbal communication skills
• Knowledge of healthcare data, including medical and pharmacy claims, Utilization Management, provider, and member demographic data. EMR data and HIE data experience a plus.
• Knowledge of Medicaid, Medicare and other government sponsored healthcare programs strongly preferred
• Proficient with writing and adapting SQL with flat files and relational databases, Databricks a plus
• Proficient in with Excel, Word and PowerPoint, PowerPivot a plus
• Proficient as a user of Microsoft Power BI as an analytic tool

Working Conditions:

• General office environment; may be required to sit or stand for extended periods of time

Compensation Range:

CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type (hourly/salary):

Organization Level Competencies

• Fostering a Collaborative Workplace Culture

• Cultivate Partnerships

• Develop Self and Others

• Drive Execution

• Influence Others

• Pursue Personal Excellence

• Understand the Business

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.