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WFH: FL
Remote only
Join PacificSource and help our members access quality, affordable care!
PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, sex, sexual orientation, gender identity, national origin, genetic information or age. PacificSource values the diversity of our community, including those we hire and serve. We are committed to creating and fostering a work environment in which individual differences and diversity are appreciated, respected and responded to in ways that fully develop and utilize each person’s talents and strengths.
Primary subject of analytic support related to support of reinsurance, large employer RFP, large employer and ASO, state and/or federally mandated reporting and analyses.Analytical role may vary and involve knowledge of value based payments, provider contract language, healthcare utilization, healthcare benefits and state and federal guidelines. The role will also collaborate with level 3 and 4 analysts and analytics management in coordination of projects with multiple departments in supporting contractually required reporting in a timely, accurate and easy to understand format for external provider audiences. Additional tasks may include assisting with components of validating data used in the VBP settlement and payment processes; initiating documentation and processes; provides financial guidance and support; supports cost savings and process improvement efforts; provides financial governance and oversight.Essential Responsibilities:
Supporting Responsibilities:
SUCCESS PROFILE
Work Experience: Three years’ experience in health insurance or related field. Healthcare analytics experience is preferred.
Education, Certificates, Licenses: Bachelor's degree in Mathematics, Computer Science, Statistics, Engineering, Health and Medical Economics, Public Health or similar research related field.
Knowledge: General knowledge of business principles, theories and concepts. Proven ability to manage multiple projects and competing deadlines. Ability to manage workload within a team environment or with minimal direct supervision. Ability to conceptualize solutions to complex problems; readily anticipates problems and identifies solutions. Ability to deal responsibly with confidential information. Ability to develop, document and adhere to department policies and procedures. General knowledge of in at least one statistical/analytical programming tools such as R, SAS, SPSS. General knowledge of other technical applications such as Tableau, Power BI and web-based database tools. Skilled in Microsoft Office: Word, Excel, PowerPoint and Outlook.
Preferred Knowledge: Familiarity with Medicare Five-Star, Oregon Quality Incentive Measures and/or NCQA HEDIS, Health Care Payment Learning & Action Network (LAN) and Alternative Payment Model framework, and Facets claims processing system. Working knowledge of medical costs is desired, while experience with medical coding and terminology. Master’s degree or above in Mathematics, Computer Science, Statistics, Engineering, Health and Medical Economics, Public Health or similar research related field preferred.
Competencies:
Building Customer Loyalty
Building Strategic Work Relationships
Contributing to Team Success
Planning and Organizing
Continuous Improvement
Adaptability
Building Trust
Work Standards
Environment: Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately less than 5% of the time.
Skills:
Accountability, Collaboration, Communication (written/verbal), Flexibility, Listening (active), Organizational skills/Planning and Organization, Problem Solving, TeamworkCompensation Disclaimer
The wage range provided reflects the full range for this position. The maximum amount listed represents the highest possible salary for the role and should not be interpreted as a typical starting wage. Actual compensation will be determined based on factors such as qualifications, experience, education, and internal equity. Please note that the stated range is for informational purposes only and does not constitute a guarantee of any specific salary within that range.
Base Range:
$64,871.24 - $110,281.11We live and breathe our values. In fact, our culture is driven by these seven core values which guide us in how we do business:
We are committed to doing the right thing.
We are one team working toward a common goal.
We are each responsible for customer service.
We practice open communication at all levels of the company to foster individual, team and company growth.
We actively participate in efforts to improve our many communities-internally and externally.
We actively work to advance social justice, equity, diversity and inclusion in our workplace, the healthcare system and community.
We encourage creativity, innovation, and the pursuit of excellence.
Physical Requirements: Stoop and bend. Sit and/or stand for extended periods of time while performing core job functions. Repetitive motions to include typing, sorting and filing. Light lifting and carrying of files and business materials. Ability to read and comprehend both written and spoken English. Communicate clearly and effectively.
Disclaimer: This job description indicates the general nature and level of work performed by employees within this position and is subject to change. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to this position. Employment remains AT-WILL at all times.
