City/State

Virginia Beach, VA

Overview

Work Shift

First (Days) (United States of America)

Be a part of an excellent healthcare organization that cares about our People, Quality, Patient Safety, Service, and Integrity. Join a team that has a mission to improve health every day and a vision to be the healthcare choice of the communities that we serve!

Sentara Health Plan is hiring for a Sr Pharmacy Data Analyst for Optima Health.

This is aFull-Timeposition, fully remote, with day shift hours and great benefits!

Work Location:

Candidates may work remotely in VA, NC, WA, NV, FL, IN, SD, GA, SC, TN, TX, WV and WI(link removed)>
Job Responsibilities

This role is part of the Cost of Care Analytics team. This position will analyze and report medical expense trends, support medical expense cost saving initiatives, assess the viability of vendor partnerships, complete ROI analyses, and support SIU and strategic expansion goals.

Requires the ability to data mine, interpret, understand, and summarize payer data including (but not limited to) medical, behavioral health, and pharmacy claims, as well as clinical, financial, member, and provider information. This position will also create summaries, reports, and dashboards using various methodologies in an effort to provide clear and concise information for stakeholder decision support. Requires excellent oral and written communication skills.

• Data mine and analyze insurance payer claims, as well as member and provider data from disparate sources using multiple criterion within the context of specified projects.
• Identify and analyze medical expense trends within inpatient, outpatient, professional, and pharmacy claims data/utilization.
• Assist cost of care stakeholders with health plan cost saving initiative ideation through data stewardship and adoption.
  
  

Job Requirements

• Required to have Bachelor's Level Degree
• Required to have 3 years of Data Analysis experience
• Required to have 1 year of Healthcare experience
• Required to have SQL
• Required to have Tableau
• Required to have Excel
  
  

Preferred Qualifications

• Preferred to have experience in Payer claims data
  
  

Benefits: Sentara offers an attractive array of full-time benefits to include Medical, Dental, Vision, Paid Time Off, Sick, Tuition Reimbursement, a 401k/403B, 401a, Performance Plus Bonus, Career Advancement Opportunities, Work Perks, and more.

For information about our employee benefits, please visit:Benefits - Sentara((link removed))

Sentara Health Plans is the health insurance division of Sentara Healthcare doing business as Optima Health and Virginia Premier.

Sentara Health Plans provides health insurance coverage through a full suite of commercial products including consumer-driven, employee-owned and employer-sponsored plans, individual and family health plans, employee assistance plans and plans serving Medicare and Medicaid enrollees.

With more than 30 years experience in the insurance business and 20 years experience serving Medicaid populations, we offer programs to support members with chronic illnesses, customized wellness programs, and integrated clinical and behavioral health services - all to help our members improve their health.

For applicants within Washington State, the following hiring range will be applied: $73,819.20 to $ 87,447.36 annually.

Join our team, where we are committed to quality healthcare, improving health every day, and provide the opportunity for training, development, growth!

To apply, please go to (link removed) and use the following as your Keyword Search: JR-41666

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Keywords: Business Analyst, Operations, Excel, SQL, Data Analysis, Tableau, Payer claims data, Payer, cost of care

Job Summary

The Healthcare Data Analyst provides data analysis support to the customer by assisting with the development of reports and/or dashboards (via data mining and summarization) to monitor program and operational performance. Promotes self-service analytics for customer adoption, understanding and use of data. Supports design of programmatic analyses and reporting capabilities in addition to business requirement definition for new analyses and performs ad-hoc analysis as directed. This position supports data quality and data stewardship functions to maintain data accuracy and identify new metrics. As a subject matter expert, the Healthcare Data Analyst Senior uses analytic skills to offer data-driven conclusions and recommendations to business partners.

As an integrated health system, Sentara delivers analytics across a wide variety of domains, including payer functions, ambulatory, acute & post-acute care and support functions. The subject matter expertise required will vary based on the specific opening, but include the following:

Medical expense and trends.

Clinical gaps and adherence.

Pay-for-performance/value-based measures.

State and Federal regulatory reporting.

Employer groups reporting and client ad-hoc reporting related to clinical and financial services.

Population health reporting & analysis.

Risk, member/patient stratification, member/patient segmentation, quality, provider scoring, and cost savings

Ambulatory, acute & post-acute quality, clinical performance, and operations reporting & analysis

Quality & performance benchmarking

Research data & analytic support

Works directly with internal customers and external provider partners.

Proficiency in SQL, Excel, and Tableau

Excellent Oral and Written Communication Skills

Problem Solving

Consultative Engagement Skills

Qualifications:

BLD - Bachelor's Level Degree (Required), MLD - Master's Level Degree

Data Analysis, Financial Analysis, Population Management, Statistics

Skills

Active Learning, Active Listening, Communication, Complex Problem Solving, Coordination, Critical Thinking, Reading Comprehension, Service Orientation, Time Management, Troubleshooting, Writing

Sentara Healthcare prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.

Per Clinical Laboratory Improvement Amendments (CLIA), some clinical environments require proof of education; these regulations are posted at ecfr.gov for further information. In an effort to expedite this verification requirement, we encourage you to upload your diploma or transcript at time of application.

In support of our mission to improve health every day, this is a tobacco-free environment.