We offer remote work opportunities for those residing in the following states ONLY – no other locations are authorized:
We offer remote work opportunities (AK, AR, AZ, *CO, FL, HI, IA, ID, IL, KS, LA, MD, MN, MO, MT, NE,NV, NM, NC, ND, OK, OR, SC, SD, TX, UT, VA/DC, *WA, WI & WY only)
~Veterans, Reservists, Guardsmen and military family members are strongly encouraged to apply~
Job Summary
This role manages healthcare data reporting, querying, and analysis for the Data Management department with direct responsibility for contact center and operations performance analysis. Oversees a team of Business Intelligence Analysts and Developers tasked with providing TriWest leadership with insights from contractual, operational, and performance data. Monitors performance on key performance indicators and identifies opportunities to improve. Evaluates performance trends and develops analysis with recommendations to optimize outcomes to better complement the Government healthcare system and help TriWest meet goals related to KPIs and quality metrics. Supports strategic initiatives related to healthcare cost management performance objectives and contractual reporting. Drives the organization towards data-driven decision making.
Education & Experience
Required:
• Bachelor’s degree in Business Administration, Healthcare, Statistics, Information Management, CIS or related field or equivalent experience
• 5+ years of data analysis and reporting experience to include developing key performance indicators and providing analysis and trending
• 3+ years of experience leading and managing reporting and analytics teams
• Advanced knowledge of Business Intelligence tools (e.g. PowerBI, Tableau, SSRS)
• Excellent verbal and written communication skills and an ability to synthesize and present results in a clear and concise manner
• Demonstrated proficiency in the use of computer systems, spreadsheet applications, and data analysis software such as SQL query language, MS Excel and MS Access
Preferred:
• Familiar with coding methods and guidelines (CPT, ICD, HCPCS, POS, DRG, Revenue)
• 3+ years of working with call center performance data
• 1 year of experience with advanced analytics tools (e.g. Python, R)
• Masters degree in Business Administration, Statistics, Public Health or other applicable discipline
• Experience with VA healthcare, military health services system, and private Managed Care programs
Key Responsibilities
• Act as an internal consultant to work across key stakeholders to gather data, perform analysis, and provide recommendations and insights to business leaders
• Contact center operations and metrics
• Execute business reporting functions, metric creation and reports that demonstrably drive operational actions and highlight wins / opportunities
• Interpret claim data using a variety of techniques, ranging from simple data aggregation via statistical analysis to complex data mining
• Drive improvements in cost efficiency, quality, and effectiveness of TriWest operations by performing data analysis to deliver actionable insights that are backed by empirical evidence
• Develop optimization analysis to determine how well TriWest’s network meets the needs of the Government based on authorization/claims patterns, discounts achieved and access to care requirements
• Collect, compile, and analyze healthcare cost and discount trends, and identify opportunities for improving/maintaining discounts based on utilization patterns
• Collaborate with others in Data Management and IT to enhance the data warehouse to include translating technical and functional requirements into meaningful information and improve healthcare reporting capability
• Train department staff on healthcare data querying, terminology, integrity, standards, and procedures
• Coach and mentor staff toward operational excellence and skill development
• Work with management to understand and interpret the impact of decisions made by retrieving and analyzing claims costs, authorizations and/or other relevant data. Work closely with various groups in the assembling of data, development and application of quantitative analysis and mathematical models for internal and regulatory reporting requirements
• Support Government reporting requirements, management and the medical management system by managing automated reports
• Develop methods for consistency and validity and review the accuracy of data and reports. Determine the best approach for presenting data in an efficient and beneficial manner
• Preparation of annual performance evaluations and development plans for assigned staff
• Perform other duties as assigned
• Regular and reliable attendance is required
Company Overview
Taking Care of Our Nation’s Heroes.
It’s Who We Are. It’s What We Do.
Do you have a passion for serving those who served?
Join the TriWest Healthcare Alliance Team! We’re On a Mission to Serve®!
Our job is to make sure that America’s heroes get connected to health care in the community.
At TriWest Healthcare Alliance, we’ve proudly been on that important mission since 1996.
Benefits
We’re more than just a health care company. We’re passionate about serving others! We believe in rewarding loyal, hard-working people who are willing to learn as they grow. TriWest Healthcare Alliance values teamwork. Join our team, fulfill your responsibilities, and you may also be considered for frequent pay raises, overtime opportunities to earn even more, recognition and reward programs, and much more. Of course, we also offer a comprehensive and progressive compensation and benefits package that includes:
- Medical, Dental and Vision Coverage
- Generous paid time off
- 401(k) Retirement Savings Plan (with matching)
- Short-term and long-term disability, basic life, and accidental death and dismemberment insurance
- Tuition reimbursement
- Paid volunteer time
*Annual base salary for Colorado and Washington State residents: $126,000 – $140,000 depending on experience*
Equal Employment Opportunity
TriWest Healthcare Alliance is an equal employment opportunity employer. Applicants are considered for positions without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability or any other consideration made unlawful by applicable federal, state, or local laws.