Focused on understanding, accessing, compiling, and reporting on healthcare claims data and the related analysis of provider contracts. Partners with contract manager to develop contracting strategy and supports all aspects of the contract negotiation process. Conducts multiple types of contract analytic modeling, e.g. physician, ancillary, or hospitals. Supports a full range of contract arrangements and pricing mechanisms. In collaboration with analytic partners, provides business intelligence and recommendations to KP leadership concerning contractual, financial and utilization information. Utilize data and evidence-based practices to objectively identify opportunities around healthcare costs and trends to strategically create competitive advantages for the organization and network development team. This role will also support the development of contracting modeling tools so as to effectively automate data mining, modeling and reporting tools.
Data mining, manipulation & analysis to support contracting initiatives.
Create and maintain contracting models, reports & dashboards; prepares ad hoc reports upon request.
Support contract modeling system development and implementation of process improvements.
Research and respond to inquiries from business units and stakeholders.
Other duties as assigned.
Minimum of three (3) years of experience in healthcare data analysis including but not limited to database/data mining creating queries, reports, and tables required.
Bachelor's degree in business, healthcare administration or related field required.
License, Certification, Registration
Ability to acquire new skills and knowledge for improved performance while working under pressure.
Solid work ethic and ability to complete tasks in a timely and efficient manner.
Effective, clear and concise communication using appropriate channels to maintain working relationships.
Solid analytical skills.
Experience using financial modeling systems and a working knowledge of related processes and procedures.
Knowledge and experience in creating multi-functional databases.
Intermediate MS Excel computer proficiency test with passing score of 70% or better.
Minimum of five (5) years of provider data analysis and health care operations experience.
Minimum of three (3) years or more working with robust database programs to include SQL and SAS.
Cost accounting capability & understanding.
Ability to assist in migration to new data platforms & systems.
Experience with hospital charge masters, understanding of how to adjust charges and impacts on reimbursement.
Understanding of provider reimbursement preferred.
Master's Degree in business, healthcare administration or related field.
Kaiser Permanente is an equal opportunity employer committed to a diverse and inclusive workforce. Applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), age, sexual orientation, national origin, marital status, parental status, ancestry, disability, gender identity, veteran status, genetic information, other distinguishing characteristics of diversity and inclusion, or any other protected status.
External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with federal and state laws, as well as applicable local ordinances, including but not limited to the San Francisco and Los Angeles Fair Chance Ordinances.