*There is one position which can be filled in any of our 3 offices (Scotts Valley, Merced or Salinas) or Remote in CA.

*This is a remote opportunity within California. In order to qualify for this role, you must currently reside in the state of California or plan to reside in the state of California at the time of starting this role.

 

WHAT YOU'LL BE RESPONSIBLE FOR

Reporting to the Provider Payment Director, you will lead the process of identifying and analyzing medical cost issues and challenges in order to develop solutions and recommendations, identify analytics and medical cost improvement opportunities, and provide proactive, strategic consultative solutions that are actionable, accessible, and auditable.  You will perform the most complex analysis and project management related to areas such as medical cost and utilization and regulatory submissions. You will also provide subject matter expertise and assist with providing orientation, mentoring and training to subordinate financial data analysts.

 

ABOUT THE TEAM

The Provider Payment team’s focus is improved medical cost and health outcomes for our members. We are truly an analytics team at heart. We are solutions based, critical thinkers with a passion for what we do. We work in a fast-paced, collaborative environment that promotes professional growth and success, embraces challenges, supports accountability and celebrates accomplishments.

 

THE IDEAL CANDIDATE 

You are curious, with a drive to discover root causes and develop new processes, possess strong analysis skills and methodology when approaching complex work . You are a critical thinker who likes to look at the complete picture to solve problems. You are highly organized with a structured and analytical approach to work. You are technically savvy, with strong knowledge of data structures, interpretation, coding, the analytic life cycle and data warehouse environments.

 

WHAT YOU'LL NEED TO BE SUCCESSFUL

To read the full position description, and list of requirements click here.

  • Knowledge of:
    • Research, medical cost analysis and reporting methods
    • General health service research, outcomes reporting/analytics and program outcomes evaluation
    • Healthcare industry specific terms and healthcare related data types and structures, including member, claims, clinical and provider data
    • Quantitative data analysis methodologies and analytical tools related to reporting medical cost analysis
    • Data modeling techniques and business analytical and data mining tools, including SQL, and data visualization tools, such as Tableau
    • Healthcare industry and healthcare information standards such as HL7, LOINC, FHIR, ICD 9/10 and CPT codes, industry standard groupers, such as ETGs, DRGs, and DCGs
  • Ability to:
    • Collect, interpret, and evaluate data, detect patterns, brainstorm solutions, consider multiple factors when making decisions, and project consequences of recommendations
    • Develop data-driven and outcome-based initiatives to improve business decision making
    • Translate data into understandable information and deliver solutions that improve business processes
    • Create systems to monitor data errors
    • Act as a technical resource, provide guidance related to area of assignment, and explain related regulations, processes, and programs
    • Manage multiple projects simultaneously, organize work, ensure accuracy of data, maintain accurate records, and achieve goals and timelines
  • Education and Experience:
    • Bachelor’s degree in Economics, Finance, Business, Healthcare Administration, Quantitative Analysis or a related field
    • A minimum of five years of financial analytics experience which included four years in a healthcare setting (a Master’s degree may substitute for two years of the required experience); or an equivalent combination of education and experience may be
      qualifying

 

OTHER DETAILS

  • This position is available to be filled remotely, in California, but our preference will always be to hire locally. Priority will be given to candidates that are in our Local Service Area
  • While this position is connected to one of our Alliance offices, we are in a fully remote work environment right now due to COVID-19. The interview and on-boarding process will be completed remotely

Additionally, all positions at the Alliance are required to meet these minimum qualifications.


OUR BENEFITS

  • Medical, Dental and Vision Plans
  • Ample Paid Time Off
  • 11 Paid Holidays per year
  • 401(a) Retirement Plan
  • 457 Deferred Compensation Plan
  • Robust Health and Wellness Program
  • EV Charging Stations
  • And many more

ABOUT US

We are a group of over 500 dedicated employees, committed to our mission of providing accessible, quality health care that is guided by local innovation. We feel that our work is bigger than ourselves. We leave work each day knowing that we made a difference in the community around us.

Join us at Central California Alliance for Health (the Alliance), where you will be part of a culture that is respectful, diverse, professional and fun, and where you are empowered to do your best work. As a regional non-profit health plan, we serve over 377,000 members in Santa Cruz, Monterey and Merced counties. To learn more about us, click here.


At this time the Alliance does not provide any type of sponsorship. Applicants must be currently authorized to work in the United States on a full-time, ongoing basis without current or future needs for any type of employer supported or provided sponsorship.

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