Center City, Philadelphia, PA
PRIMARY FUNCTION: Responsibilities include the production of Population Health "Key Performance Indicators and Metrics" used to measure and quantify Jefferson's Population Health experience through real-time reporting, early indicator reporting, and prospective and retrospective analyses. Produces analytics used to measure and quantify Jefferson's and associated business partners' experience through reporting using CMS data and other internal/external data.
- Provides analytical support (consultation, design, analysis) to business units to understand and monitor performance as it relates to cost and quality.
- Interfaces directly with customers and management to negotiate requirements (understand customer needs and provide consultation on options to best meet that need) with customers to ensure optimal value and timely delivery.
- Provides direction and/or consultation on analytical approach to peers and customers. Uses business knowledge to anticipate business questions and needs and proactively identify and implement solutions. Identifies gaps in business reporting and proactively identifies and implements solutions.
- Performs all aspects of actuarial informatics analysis including;data acquisition and data management, advanced SAS or SQL programming, advanced data visualization, quantitative and qualitative data analysis,
- Interprets and synthesizes outcomes and conclusions
- Creates written narrative summaries that compliment many of the key performance indicators and metrics, or analytics outlining trends of interest, opportunities for intervention or consideration, changes or shifts in data elements from one time period to another, etc.
- Maintains proficiency and expertise in Health Plan data applications, state of the art business intelligence software and reporting tools that include, but are not limited to, MS SQL Server Components (Query Analyzer & coding, Analysis Server, Stored Procedures, Jobs, and Functions), Business Objects (Crystal Reports, Crystal Enterprise, Crystal Analysis, OLAP, and Xcelsius), SAS, Microsoft Office (Word, Excel, PowerPoint, and Access) and grouper and predictive modeling software (3M, CGI, and MEDai) to prepare complex multi-factorial analysis. Synthesizes and Interprets analyses.
- Interacts with co-workers, visitors, and other staff consistent with the values of Jefferson.
OTHER FUNCTIONS AND COMPETENCIES:
- Demonstrates strong mathematical, statistical, financial, technical, interpersonal, organizational, project management skills, and ability to maintain confidentiality.
- Knowledge of healthcare coding structures and payment methodologies.
- Advanced programming in SAS, SQL Query Construction or other programming language.
- Advanced understanding of relational database systems and uses.
- Demonstrated strong business acumen.
- Effective verbal and written communication and presentation skills appropriate for communication with both external clients and senior management.
- Evidence of independent analytical and problem solving skills.
- Strong Microsoft Office Excel skills Working knowledge of other Microsoft Office applications (Word, Access, PowerPoint).
- Exceptional time management and organizational skills.
- Ability to effectively handle numerous priorities simultaneously.
- Ability to serve department as a subject matter expert.
- Demonstrated ability to identify problem areas and take initiative to identify and implement appropriate solutions Self-motivated
- Must possess a comprehensive understanding of clinical or payer operational processes and ability to evaluate impacts on data compilation and reporting.
- Provides supervisory guidance to less experienced analysts.
- Works with Vice Presidents, Medical Directors, Clinical Operations, Finance, Network Contracting, IT and other Jefferson departments or stakeholders.
- Participates in all required meetings, educational overview sessions, product implementation and review sessions as communicated by the Director, Actuarial Informatics
- Performs other duties as required for which the employee is qualified to perform.
Bachelor’s Degree in Business, Mathematics, Computer or other data relevant field required
- Minimum of 5 years related professional work experience in a progressive healthcare setting required.
- Minimum of 4 years related professional work experience in a progressive healthcare setting required and passage of at least one (1) Society of Actuarial (SOA) exams and active in the Exam Program (total of 4 exams completed).
- Advanced programming in SQL, SAS, and/or R Query Construction or other programming language.
Jefferson Health delivers state of the art healthcare services to patients throughout the Delaware Valley and southern New Jersey. Jefferson (Philadelphia University + Thomas Jefferson University) provides more than 8,400 students from nearly 40 states and 40 countries with 21st century professional education. Combined, we have over 30,000 employees.
Jefferson Health, with 14 hospitals (seven are Magnet designated by the ANCC for nursing excellence) and 40+ outpatient and urgent care locations, offers a broad range of primary and complex, highly specialized care that touches the lives of more than four million patients annually. U.S. News & World Report has ranked Thomas Jefferson University Hospital among the nation’s best in eight specialties. Jefferson Health also includes the NCI designated Sidney Kimmel Cancer Center; it is one of only 70 such centers in the nation.
Thomas Jefferson University has ten colleges and three schools that offer more than 160 undergraduate and graduate programs. Our University is dedicated to inter-professional and transdisciplinary approaches to learning that offer a vibrant and expandable platform for professional education. Through this unique model, we are preparing our students for current and yet to be imagined careers.
As an employer, Jefferson maintains a commitment to provide equal access to employment. Jefferson values diversity and encourages applications from women, members of minority groups, LGBTQ individuals, disabled individuals, and veterans.