PacificSource Health Plans

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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.

Provide essential data support and coordination activities for various business critical analysis and reporting needs to help achieve the goals and initiatives identified in PacificSource Strategic Plan, as well as in alignment to departmental mission and vision. This role will provide analytics support related to healthcare cost and utilization, identification of opportunities and evaluation of health services activities, including, but not limited to, care management, disease management, wellness programs, quality programs and early identification of high risk populations with directions from level 3 and 4 analysts and analytics leadership. Analytical role may vary and involve diverse array of projects and opportunities to gain knowledge of contract language, healthcare utilization, performance analysis for clinical programs, state and federal guidelines. .

Essential Responsibilities:

• Draft and develop reports and analyses to support internal and external business processes, as well as assist in helping the organization in compliance of state and federal regulatory requirements.
• Facilitates routine reporting and ad-hoc information requests by running pre-programmed code scripts and macros and by collaborating with senior analysts in creating queries/reports through the appropriate programs.
• Develop general health insurance business content knowledge as well as specific knowledge related to assigned business areas of analytics support.
• Prepare assigned ad hoc analyses related to cost and utilization opportunities.
• Contribute to and initiate development and maintenance of documentation and training materials including job aids.
• Collaborate with senior analysts to perform statistical analysis and modeling techniques on large data sets, including the use of standard statistical packages such as R or Python as directed.
• Complete analyses around health care data, utilization, quality initiatives, outcome, and performance analysis for clinical programs with directions.
• Assists with quality assurance adherence to ensure accuracy, completeness, and reliability of project-related information data resources and reporting initiatives such as participating in data validation projects and providing feedback on development of unit testing, error checks and validation processes.
• Perform data extraction to meet project requirements as directed. This would include cleaning, transformation and pre-processing data using software programs such as t-SQL, SAS, etc.
• Support the development of data visualization solutions that allow customer to interact with the data using data visualization software solutions such as Tableau or Microsoft Power BI.
• Support presentation of complex data, analysis and findings to teams in a way that is clear and understandable.
• Gather and generate information used to understand health costs and assist with making recommendations to health plan on cost analysis.
• Assist in the development of capabilities and performance measurements, such as collaborating with level 3 and 4 analysts in supporting NCQA/HEDIS audit compliance and accreditation by compiling and maintaining needed reporting, effective and satisfactory procedural documentations, information/data flows, and business rules.

Supporting Responsibilities:

• Meet department and company performance and attendance expectations.
• Follow the PacificSource privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information.
• Perform other duties as assigned.

SUCCESS PROFILE

Work Experience: 3 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, Biostatistics, Epidemiology, Health and Medical Economics, Public Health or similar research related field required.

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 and 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 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. Working knowledge of medical costs is desired, while experience with medical coding and terminology. Entry level understanding of advanced analytics methods (such as machine learning, multivariate statistics, cluster analysis, simulation and neural networks). Master’s degree or above in Mathematics, Computer Science, Statistics, Engineering, Health 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, Teamwork

Our Values

We 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.