Provider Network Specialist jobs in Miami, FL

* In person - Not remote - Authorization to work in the US required *

Position Summary

Responsible for supporting the Medical Economics Director with the overall data analysis activities related to Business Development and the HOPCo Network Solutions Joint Venture. The Medical Economics Analyst II will serve as a departmental liaison between the company’s internal teams, potential business partners, current health plans, and any other external agencies. This role will be providing administrative support to the head of the department, ensuring achievement of all departmental goals and be accountable for identifying & reporting emerging issues quickly and providing the detailed analysis to identify the drivers and suggest potential solutions. Responds to varied ad-hoc data focused assignments.

Duties and Responsibilities

• · Responsible for both requesting and receiving external data (i.e., claims utilization files, membership files etc..) and collaborating with external counterparts and necessary internal teams to ensure that the established SOPs of the department are being followed.
• · Conducting necessary data validation checks to ensure accuracy, completeness, and overall data integrity for analyses.
• · Departmental initial lead on collaborative efforts with Business Development, providing all data analysis support.
• · This Position will act as an Auxiliary to the Director for Business Development related activities including but not limited to analyses and proposals.
• · Provides support in data analysis presentation process and models with both current and new business opportunities.
• · Collaborating closely with Medical Economics Teammate in updating the executive high level network overview PowerBI dashboards on quarterly basis.
• · Responsible for the publishing/sharing the executive high level network overview PowerBI dynamic dashboards to leadership team on quarterly basis.
• · Performing data analyses on current and prospective business models and benchmarking against comparable markets and nationally reported metrics.
• · This role will frequently involve conducting root cause analysis exercises to uncover opportunities arising from system issues or other unidentified problems.
• · In charge of tracking, monitoring, and reporting out departmental Key Performance Indicators (KPIs).
• · Coordinates all Medical Economics presentations, research, and meetings.
• · This Position will be working closely with the Medical Economics Director and the CMO on new analyses of Population Health Management.
• · Responsible for designing and supporting Data Models optimized to support analytical tools such as PowerBI
• · Special projects as assigned.

Knowledge

• · Minimum of five (5) years of related Health Care or Analytic experience.
• · Bachelor’s degree in Mathematics, Statistics, Finance, Business, Operations or Healthcare Management preferred.
• · Proficient in Microsoft Office Suite. Strong Excel and Power Point skills are necessary as well as Access.
• · Proficient in PowerBI (or equivalent data visualization tool i.e. Tableau) for data analytics.
• · Working knowledge of scripting or data mining tools like SQL, R, Python, SAS, Java/MapReduce, Aster, etc. required
• · ETL experience is a plus.
• · Conventional understanding of applicable data privacy practices, HIPPA & Healthcare regulations would be a plus.

Skills

• Excellent understanding of principles and best practices of data collection & analytics.
• Experience in leading and coordinating teams and intra-departmental initiatives.
• Possesses excellent verbal and written skills with ability to convey and understand complex ideas.
• Strong interpersonal, consultative, and relationship building skills.
• Experience in Quantitative Analytics & Regression Modeling
• Detail-oriented with a high level of organizational skills.
• Strong analytical and problem-solving skills
• Research Skills
• Thoroughness

Job Type: Full-time

Pay: $55,000.00 - $70,000.00 per year

Benefits:

• 401(k)
• Dental insurance
• Disability insurance
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Parental leave
• Tuition reimbursement

Experience level:

• 5 years

Schedule:

• 8 hour shift

Experience:

• related Health Care or Analytic: 5 years (Required)

Language:

• English (Required)

Ability to Commute:

• Doral, FL 33178 (Required)

Work Location: In person