About this role
Provide business intelligence support for MercyCare’s Actuarial and Underwriting department along with other MercyCare directors, managers and clients in making informed business decisions based on past and present data collected, curated, reconciled and reported from all available data sources.
Responsibilities
ESSENTIAL DUTIES AND RESPONSIBILITIES
Maintenance and extraction of information from the data warehouse and other data sources with an emphasis on creating reports and visualizations for management.
Monthly reconciliation with Finance of key control totals underpinning loss ratio reporting along with assistance in the reconciliation of reports developed outside of MercyCare (by MHS).
Annual maintenance of risk adjustment scoring algorithm and monthly updates of MercyCare risk scores to support reserving.
Support prioritization of pended claim processing during Q1 of each calendar year for risk adjustment optimization.
Assist Finance in the completion of Medicaid financial reporting.
Monthly updating of enrollment and loss ratio budget vs. actual along with an analysis of variance.
Support or completion of certain regulatory financial surveys, such as the EDGE Server baselines, NAIC survey and the 1332 Waiver survey.
Auditing of operations as needed, such as an investigation of duplicate claims, Medicaid pricing or fee schedule analysis.
Support of monthly commercial reinsurance notification and filing process.
Development of utilization and cost trend reporting.
Creation of data sets supporting ACA Single Risk Pool pricing and end of year Statement of Actuarial Opinion
Extraction and initial preparation of large group experience-rated renewals.
Creation of additional meaningful utilization reports for large group clients.
Staging of data for ad hoc actuarial studies.
EDUCATION & EXPERIENCE
Bachelors degree in a financial field with strong data handling and analysis skills.
Directly related work experience will be considered in lieu of targeted degree (Five years prior business experience with spreadsheet design, databases, and ad hoc report writing programs required).
Healthcare experience a plus.
CERTIFICATION/LICENSURE
Relevant certifications preferred (i.e. SQL and Microsoft Office).
Benefits
Mercyhealth offers a generous total rewards package to eligible employees including, but not limited to:
· Comprehensive Benefits Package: Mercyhealth offers a retirement plan with competitive matching contribution, comprehensive medical, dental, and vision insurance options, life and disability coverage, access to flexible spending plans, and a variety of other discounted voluntary benefit options.
· Competitive Compensation: Mercyhealth offers market competitive rates of pay and participates in various shift differential and special pay incentive programs.
· Paid Time Off: Mercyhealth offers a generous paid time off plan, which increases with milestone anniversaries, to allow employees the opportunity for a great work-life balance.
· Career Advancement: Mercyhealth offers a number of educational assistance programs and career ladders to support employees in their educational journey and advancement within Mercyhealth.
· Employee Wellbeing: Mercyhealth has a focus on wellbeing for employees across the organization and offers a number of tools and resources, such as an employer-sponsored health risk assessment and a Wellbeing mobile application, to assist employees on their wellbeing journey.
· Additional Benefits: Mercyhealth employees have access to our internal and external employee assistance programs, employee-only discount packages, paid parental and caregiver leaves, on-demand pay, special payment programs for patient services, and financial education to help with retirement planning.
Other facts
About Mercyhealth
At Mercyhealth, our doctors, nurses and staff are committed to making lives better for our patients and their families. They bring knowledge and innovation to ensure that our patients receive world-class health care, close to home.
As an integrated health system, we provide exceptional, coordinated health care for almost every need. Integration improves access to services, technology and treatments, and leads to better outcomes. To best serve our patients, our integration centers around four core service areas: hospital-based services, clinic-based services, post-acute and retail services (home health, hospice, pharmacies, etc.), and a wholly owned and operated insurance company.
At the heart of our organization are more than 7,000 doctors, nurses, staff and volunteers who live the Mercyhealth mission of providing exceptional health care services with a passion for making lives better. We’re committed to working together to make lives better for our patients and their families.
Our passion drives and inspires us to do our very best, and we continuously look for ways to make each life better with the utmost care and professionalism. This can be as complex as a cutting-edge procedure or as simple as a smile. Nothing is ever too small or taken for granted. Everything matters.
What you'll do
- The Business Intelligence Analyst will provide support for data extraction, reporting, and reconciliation to assist management in decision-making. Key tasks include maintaining risk adjustment scores, supporting financial reporting, and developing utilization reports.
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