Independent Living Systems
Senior Analyst, Research & Data Scientist
Independent Living Systems, Miami, Florida, us, 33222
ABOUT US
Join us in making a career in Independent Living Systems, an industry leader in managing home and community-based programs for over 20 years. Independent Living Systems, LLC and its subsidiaries offer a comprehensive range of clinical and third-party administrative services to managed care organizations and providers that serve high-cost, complex member populations in the Medicare, Medicaid, and Dual-Eligible Market. ILS provides tailored integrated solutions aimed at improving health outcomes while rebalancing costs, addressing social determinants of health and connecting members with community-based resources.
Position Summary
Under the guidance of the VP, Analytics, the Medical Economics Data Analyst is responsible for in-depth analysis to support operational functions to improve clinical, utilization, operational, and financial performance of the company's lines of business. This position is critical in measuring the impact of company solutions, identifying unusual variances in performance, conducting root cause analysis, and generating actionable insights to enable pertinent areas to make informed decisions.
Essential Functions
Validate, transform, and model health care claims, enrollment, and operational data to improve decision making, using statistical analysis to identify patterns, correlations, and actionable results.
Work closely with business stakeholders and source system owners to research data anomalies and provide recommendations for resolutions.
Collaborate with other functional areas such as Finance, Care Management, Quality, Clinical Services, Claims Processing, Health Plan Operations.
Maintain detailed documentation, including data issues and resolution, methodology employed, decisions made, and reports delivered.
Communicate data-driven insights and recommendations to internal stakeholders, including executive leadership, soliciting and incorporating feedback as appropriate.
Perform other duties as required or assigned.
Education and Experience
Master’s degree in health informatics, epidemiology, biostatistics, finance, economics, actuarial services, or related field.
Minimum five years of experience working with claims data, risk models, statistical analysis and predictive modeling, preferably in the health insurance field.
Required Skills
Proficient in Microsoft Office Suite, with advanced skills in Microsoft Excel.
Proficient in SQL or other data query languages.
Statistical analysis, predictive modeling and study design expertise.
Understanding of healthcare stakeholders, measures of quality, and basic data sources.
Experience with data visualization.
Ability to apply knowledge of mathematics, probability, statistics, principles of finance and business to calculate financial, utilization, and clinical outcomes.
Professional attitude and appearance.
Solid written and verbal communication skills.
Ability to be resourceful and proactive when issues arise.
Excellent organizational skills and attention to detail.
Multitasking and time-management skills, with the ability to prioritize tasks.
#J-18808-Ljbffr
Join us in making a career in Independent Living Systems, an industry leader in managing home and community-based programs for over 20 years. Independent Living Systems, LLC and its subsidiaries offer a comprehensive range of clinical and third-party administrative services to managed care organizations and providers that serve high-cost, complex member populations in the Medicare, Medicaid, and Dual-Eligible Market. ILS provides tailored integrated solutions aimed at improving health outcomes while rebalancing costs, addressing social determinants of health and connecting members with community-based resources.
Position Summary
Under the guidance of the VP, Analytics, the Medical Economics Data Analyst is responsible for in-depth analysis to support operational functions to improve clinical, utilization, operational, and financial performance of the company's lines of business. This position is critical in measuring the impact of company solutions, identifying unusual variances in performance, conducting root cause analysis, and generating actionable insights to enable pertinent areas to make informed decisions.
Essential Functions
Validate, transform, and model health care claims, enrollment, and operational data to improve decision making, using statistical analysis to identify patterns, correlations, and actionable results.
Work closely with business stakeholders and source system owners to research data anomalies and provide recommendations for resolutions.
Collaborate with other functional areas such as Finance, Care Management, Quality, Clinical Services, Claims Processing, Health Plan Operations.
Maintain detailed documentation, including data issues and resolution, methodology employed, decisions made, and reports delivered.
Communicate data-driven insights and recommendations to internal stakeholders, including executive leadership, soliciting and incorporating feedback as appropriate.
Perform other duties as required or assigned.
Education and Experience
Master’s degree in health informatics, epidemiology, biostatistics, finance, economics, actuarial services, or related field.
Minimum five years of experience working with claims data, risk models, statistical analysis and predictive modeling, preferably in the health insurance field.
Required Skills
Proficient in Microsoft Office Suite, with advanced skills in Microsoft Excel.
Proficient in SQL or other data query languages.
Statistical analysis, predictive modeling and study design expertise.
Understanding of healthcare stakeholders, measures of quality, and basic data sources.
Experience with data visualization.
Ability to apply knowledge of mathematics, probability, statistics, principles of finance and business to calculate financial, utilization, and clinical outcomes.
Professional attitude and appearance.
Solid written and verbal communication skills.
Ability to be resourceful and proactive when issues arise.
Excellent organizational skills and attention to detail.
Multitasking and time-management skills, with the ability to prioritize tasks.
#J-18808-Ljbffr