Business Analytics Consultant (Healthcare Data Analyst)

Mid-Atlantic Permanente Medical Group

MAPMG is an Equal opportunity Employer. To learn more, view Equal Employment Opportunity is the Law in English or Equal Employment Opportunity is the Law in Spanish. We also participate in the E-Verify program, as required by law.

MAPMG is committed to providing reasonable accommodations for qualified individuals with disabilities and disabled veterans during our job application procedures. If you need assistance or a special accommodation, you may contact us at

[email protected]

Job Category: Finance
Requisition Number: BUSIN005387
Posted: 2022-09-08
Full-Time
Regional Office, 18801, 2101 East Jefferson St., Rockville, MD, 20852, USA

Who We Are:

The Mid-Atlantic Permanente Medical Group, (MAPMG) is one of the nation’s premier multispecialty medical groups and is the largest integrated medical group in Maryland, Virginia and the District of Columbia. Founded in 1980, the medical group has more than 1,700 Permanente physicians spanning more than 50 subspecialties. Together, we serve approximately 800,000 Kaiser Permanente members in Maryland, Virginia, and the District of Columbia at 34 area medical centers, plus several community hospitals and skilled nursing facilities.

Job Summary:

We are seeking a Business Analytics Consultant to be a part of the Utilization Management and Claims Analytics Department of MAPMG. The Consultant drives strategic qualitative and quantitative analysis, including claims data analysis, in line with organizational objectives and support of overall Outside Medical referral strategy decisions.

This highly visible role includes frequent interactions with mid to senior level management support teams. The Consultant provides data analysis, data visualization, report automation solutions, analytical decision support services and technical expertise across a variety of data sources including claims, the electronic medical record, and referrals reporting. The Consultant is responsible for complex multi-faceted data consolidation, integration, and analysis across multiple information platforms and functional areas throughout the organization and transforms data into actionable insights. Assists in developing performance monitoring reports and processes for claims administration. The Consultant also interprets and presents claims reports to senior leadership, collaborating with the MAPMG Regional Medical Director and Associate Medical Director of Healthcare Utilization to provide a data-driven strategic approach to claims review and external referrals.

Responsibilities:

• In line with MAPMG’s strategic mission and objectives, works closely with the Regional Medical Director of Utilization Management to plan and execute data studies and analysis used for critical decision making across the spectrum of Referrals and Outpatient Internalization.
• Applies advanced analytical processes to the planning, design, and implementation of financial and nonfinancial data with a focus on improving program effectiveness
• Keeps current with industry payment methods of reimbursement to include, but not limited to Medicare Severity-Diagnosis Related Groupers (MS-DRGs), Center for Medicare & Medicaid Services Resource Based Relative Value Scales (CMS-RBRVS)
• Familiarity with Healthcare Common Procedure Coding System (HCPCS) and Current Procedural Terminology (CPT)
• Works collaboratively with all vested parties within PMG and KFHP, both regionally and program wide, including but not limited to finance, medical group operations, contracting, claims administration, member services, membership administration, benefits administration, provider relations, and others.
• Provides analytical consulting services on the use and interpretation of analyses, reports, methodologies and source data to mid-management and senior leadership
• Applies analytical, technical, and writing skills to support facilitation of executive briefings
• Exercises independent judgment within generally defined practices and policies in selecting methods and techniques for obtaining defined results
• Develops project plans which identify issues, solutions, performance metrics and resource requirements in achieving department initiatives

Qualifications:

• Bachelor’s Degree in business, computer science, information systems or mathematics, or equivalent experience required
• Master’s Degree preferred
• Minimum of four (4) years of work experience (preferably in the healthcare industry) with demonstrable results.
• Minimum of two (2) years of consulting/data reporting analytics experience or experience in data mining/visualization analysis tools
• Demonstrates excellent leadership and collaboration abilities, along with solid time management and problem-solving skills
• Experience with hospital, physician, or ancillary provider reimbursement methods for commercial and government payers Comprehensive knowledge of Medicare payment methods preferred
• Self-motivated, high-energy individual with ability to work independently and multi-task in a fast-paced environment
• Ability to network and build internal and external relationships
• Experience with prevalent managed care products including HMO, PPO, POS, EPO, CDHP and multiple funding options including fully insured and self-funded plans
• Excellent public presentation, time management, problem solving, analytical, organizational, written, and verbal skills.
• Expert skills with or ability to learn software including Microsoft Word, Excel, Power Point, Access, Project, Visio, SQL, SAS, Tableau, Python and Contract Management Software

Competitive Benefits:

• Competitive compensation package
• Comprehensive benefits including 100% employer-funded medical and dental insurance premiums for employees and families
• Great work/life balance
• Generous paid time off
• Maternity and parental leave
• Pension plan and 401(k) retirement plan
• Life insurance, and short-term disability and long-term disability coverage
• Education reimbursement

Equity, Inclusion, and Diversity:

MAPMG continuously works to identify and mitigate healthcare inequities, and that starts with providing an inclusive, supportive environment for our employees. We encourage applicants of any race, color, religion, sex, sexual orientation, gender identity, or national origin who value diversity and will commit to practicing culturally competent healthcare.

External hires must pass a background check/drug screen.

We are proud to be an equal opportunity/affirmative action employer.

Executive Order 11246 requires affirmative action and prohibits federal contractors from discriminating on the basis of race, color, religion, sex, sexual orientation, gender identity, or national origin. Contractors also are prohibited from discriminating against applicants or employees because they inquire about, discuss, or disclose their compensation or that of others, subject to certain limitations.

PI198413662

Apply Here