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General Information

Req ID
New York
Work Type

Description and Requirements

The Senior Healthcare Analyst is responsible for monitoring risk pool performance, communicating financial results and identifying areas of opportunity for Healthfirst and hospital senior management. The Senior Healthcare Analyst will contribute to a broad set of projects across the department. More about the team, and the role: Transactional healthcare data is the lifeline for our value-based payment model. The Risk Adjustment & Encounters Reporting team is unique, as it relies on establishing workstreams and developing partnerships across the care continuum to ensure that the member’s health status is accurately represented through encounters prior to their submission to Centers for Medicare & Medicaid Services, and the New York State Department of Health. As a Healthcare Analyst – your role will be critical towards our efforts for accurate risk scores.

Job Description:

  • Produce and manage annual hospital performance review packets.
  • Monitor costs and revenue trends for hospitals and identify route cause of developing trends.
  • Understand and analyze impacts of new program changes such as new benefits or new populations.
  • Prepare monthly analysis for analytic council meetings.
  • Respond to requests for analysis and provide analytic support to network management department and our owner hospitals.
  • Pull data from warehouse using Statistical Analysis System (SAS)/Structured Query Language (SQL) code and generate reports using SAS.
  • Manage and organize bi-monthly network management meetings to discuss analysis requests, inform network management on the latest financial trends, and to keep abreast of the changes occurring in our provider community.
  • Keep abreast of New York Medicaid and Medicare reforms and their impact on the health plan and owner hospital performance.

Minimum Requirements:

  • Bachelor’s degree from an accredited institution.

  • Proficiency in SQL (Script Development, Joins) – using PostgreSQL, MS SQL Server, MySQL and Advanced MS Excel Skills (Pivot Table Creation, Complex formula development)
  • Data Visualization Experience (Tableau or Qlik View or, Power BI)
  • Experience in modeling financial impact of provider reimbursement changes.
  • Experience in supporting Network Management analytical requests.
  • Self-motivated, creative problem solver who can work independently and collaborate through strong communication and interpersonal skills.
  • Strong project management experience and ability to handle multiple projects in a fast paced environment.

Hiring Range*:

  • Greater New York City Area (NY, NJ, CT residents): $81,100 - $117,470

  • All Other Locations (within approved locations): $71,600 - $106,505

As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision.

In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live.

*The hiring range is defined as the lowest and highest salaries that Healthfirst in “good faith” would pay to a new hire, or for a job promotion, or transfer into this role.

WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, gender identity, sexual orientation, national origin, age, genetic information, military or veteran status, marital status, mental or physical disability or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.