Job Description

Overview UMWA Health and Retirement Funds provides pay range information. The actual pay is based on skills and experience; talk with your recruiter to learn more. Base pay range $89,730.00/yr - $144,516.00/yr Direct message the job poster from UMWA Health and Retirement Funds Position The Healthcare Data Analyst performs complex financial and statistical analyses and produces reports crucial to the operation of the Funds health benefits programs. The Analyst combines knowledge of health policy, demographic and healthcare financing/delivery issues with SAS programming and other analytic tools to manage and analyze large claims datasets. Safe handling of beneficiary data and timeliness/accuracy of work products are essential. Responsibilities Perform data management, analysis, and interpretation of large healthcare datasets from multiple information systems and prepare reports of results. Tasks include: creation of multiple working SAS datasets each month; downloading data and reports from outside vendors; examining data and reports for anomalies and inconsistencies, and raising questions about data quality when in doubt. Produce information for Trustees, internal stakeholders, outside vendors, auditors, and government programs (e.g., beneficiary population and status; healthcare expenditures and IBNR calculations; federal program payments from Medicare Part B and RDS; disease prevalence by geographic area). Generate and analyze claims runout reports; estimate outstanding gross and Medicare liabilities; estimate future health expenses based on actuarial projections; determine allocations of Medicare reimbursement among health plans. Apply understanding of each health plans financing, demographics, and plan design to ensure consistency across work products. Create reports and analyses of vendor networks and care management programs (e.g., DME, Non-Emergency Transportation, Hearing Aid, Caregiver Support, Complex Case Management, Flu Vaccination Campaign). Respond to ad hoc requests for statistical research and analysis; advise on methodology, data sources, and analytic approaches. Produce detailed analyses using mapping software to support management of provider networks and health plan operations. Review current academic literature and apply findings as appropriate. Adhere to all Funds policies to comply with HIPAA requirements. Provide peer review to other staff working on related tasks; may travel occasionally for business or professional development; assist with special projects as required. Qualifications Master's degree (or comparable degree) in economics, statistics, health services research, policy analysis, public health, healthcare financing and delivery issues, or program evaluation; plus two years of healthcare data analysis experience; or one year in related departmental requirements. Technical knowledge: healthcare actuarial projections, risk-adjustment methodologies, statistical modeling, survey design/sampling/analysis; proficient in SAS programming and data management; strong spreadsheet, database (Access/SQL), and mapping software skills. Communication: ability to present complex information clearly to managers, beneficiaries, vendors, and counsel; interpret business publications and regulations. Mathematical skills: advanced understanding of probability, statistical inference, and practical application of fractions, percentages, ratios, and proportions. SAS programming certification is highly desirable. Physical & Work Environment Typical requirements include sitting, using hands, walking; travel occasionally; work under tight deadlines; environment with moderate noise; accommodations available as needed. #J-18808-Ljbffr UMWA Health and Retirement Funds

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