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Analyst I - Actuarial - Full Time - Days at ProMedica Health

Posted in Other 30+ days ago.

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Type: Full Time
Location: Maumee, Ohio

Job Description:

Job Title
Analyst I - Actuarial - Full Time - Days
Office / Administrative / Clerical
Organizational Unit
ProMedica - Paramount - Paramount - Actuarial (8765)
Maumee, OH 43537 US (Primary)
Job Description

At Paramount, we offer insurance to both large and small groups and also cater to Medicare (Paramount Elite) subscribers in northwest Ohio and southeast Michigan. Our Medicaid product (Paramount Advantage) services those living in the state of Ohio. We maintain an accreditation by the NCQA the National Committee for Quality Assurance for our Ohio HMO, Elite and Advantage products. We re also part of ProMedica, which is ranked the second most integrated health system in the U.S. and No. 1 in the Midwest. For more information about Paramount, please visit our website

Paramount Actuarial Team is recruiting for an Business Analyst to join their team. The Analyst will work independently to assist in the collection and analysis of risk score data and to develop dashboards and reports for both the leadership team and risk team members. They work collaboratively with internal teams and external vendors to help Paramount reach strategic targets for both revenue and accuracy of coding.

The principal accountabilities:

* Advanced technical knowledge of analytics; ability to use data sets to draw conclusions, identify trends and ability to reach credible conclusions through use of in-house software applications to monitor and report on risk score data.

* Based on in depth data/process analysis, identify possible opportunities for risk score improvement.

* Troubleshooting of coding and data issues, identification of the root causes and implementation assistance of necessary updates.

* Assist in assessment of ROI on risk score efforts.

* Collect and report on information regarding the predictive modeling of company risk score to assist with budgets and ROI projections.

* Preparation of formal and informal presentations to help communicate objectives, processes, and recommended strategies that represent progress and team goals.

* Ability to identify alternative methods of accomplishing defined tasks, especially when obstacles or limitations make the first solution ineffective.

Job Requirements

* Bachelor s degree in Business, Finance, Math, IT, or Statistics required; MBA or MHA preferred.

* Experience in automated information systems required; experience extracting data to applications required. Experience with business intelligence applications required.

* Minimum 1-3 years business experience required; Experience in healthcare setting preferred.

* Experience with DRG, CPT, ICD-9, ICD -10 coding concepts as well as HCCs and CDPS risk adjustment models preferred.

* Experience using Microsoft Office programs, especially Excel, Word, Access, and Power Point required.

* Excellent verbal and written communications skills sufficient to interact will all levels of employees required.

* Must be adaptable to change, display qualities of initiative and be able to work independently

* Exhibit strong analytical and problem solving skills

* Ability to generate quality work product under tight deadlines in a dynamic, fast-paced environment.

* Demonstrate creativity and be able to suggest innovative solutions to business challenges

ProMedica is a mission-based, not-for-profit integrated healthcare organization headquartered in Toledo, Ohio. It serves communities in 30 states. The organization offers acute and ambulatory care, an insurance company with a dental plan, and post-acute and academic business lines. The organization has more than 70,000 employees, 13 hospitals, 2,700 physicians and advanced practice providers with privileges, 900+ healthcare providers employed by ProMedica Physicians, a health plan, and 450 assisted living facilities, skilled nursing and rehabilitation centers, memory care communities, outpatient rehabilitation clinics, and hospice and home health care agencies. Driven by its Mission to improve your health and well-being, ProMedica has been nationally recognized for its advocacy programs and efforts to address social determinants of health.

Qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, religion, sex, pregnancy, sexual orientation, gender identity or gender expression, age, disability, military or veteran status, height, weight, familial or marital status, or genetics.

Equal Opportunity Employer/Drug-Free Workplace Employee Exemption Type
Job Type
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On-call Requirements

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