Job Description

This position offers a hybrid or remote work option. Note, quarterly on-site requirement in Brooklyn, Ohio.

Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.6 million Ohioans through our high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans.

Medical Mutual’ s status as a mutual company means we are owned by our policyholders, not stockholders, so we don’t answer to Wall Street analysts or pay dividends to investors. Instead, we focus on developing products and services that allow us to better serve our customers and the communities around us and help our members achieve their best possible health and quality of life.

Responsibilities

Senior Value-Based Contracting Data Analyst

Working under limited supervision, coordinates the operational infrastructure for the Value Based Contracting (VBC) provider incentive program. Develops and maintains internal and external data flows to optimize analytics tool (EZ Info) capabilities for value based contracting programs. Acts as a primary liaison with vendor. Makes recommendations on process improvement opportunities with respect to performance against Value Based Contracting goals and objectives.

• Manages/directs data flow between VBC vendor and the Company including identifying needed data, formats, fields, overseeing the accuracy of data pulls, timing, storage, and documentation.
• Manages the relationship with vendor including identifying additional development needs, scoping, reviewing change orders and associated costs.
• Supervises EZ Info tool configurations–user permissions, structures, report development, automation, and exports and recommends opportunities to enhance existing capabilities.
• Collaborates with capitation payment team and sets up capitation contracts within the pricing and payment tool (EZ Cap).
• Stays current on provider contracting processes, regulations, and best practices. Acts as a primary liaison with other departments to support value based contracting operations.
• Orients, trains, and assists more junior level Analysts.
• Performs other duties as assigned.

Lead Value-Based Contracting Data Analyst

Working under minimal supervision and with some latitude for decision making, leads and coordinates across multiple areas, the operational infrastructure for the Value Based Contracting (VBC) provider incentive program. Advises on the development of VBC analytics strategy and leads implementation and continuous improvement. Optimizes analytics tools (VBCA and EZ Cap) capabilities for value based contracting programs. Manages vendor relationship.

• Helps devise and implement VBC analytics strategy, priorities, and continuous improvement of analytics to deliver actionable results in support of VBC programs.
• Manages/directs data flow between VBC vendor and the Company including identifying needed data, formats, fields, overseeing the accuracy of data pulls, timing, storage, and documentation.
• Manages the relationship with vendor including identifying additional development needs, scoping, reviewing change orders and associated costs.
• Lead cross-functional teams to establish VBC data instrumentation and standards.
• Creates technical specifications, test plans, and dataflow diagrams. Establishes and ensures adherence to quality assurance guidelines including the documentation, review, and approval of all VBC project related artifacts. Develops and implements policies and procedures.
• Supervises VBCA and EZ Cap tool configurations–user permissions, structures, report development, automation, and exports and recommends opportunities to enhance existing capabilities.
• Collaborates with internal and external groups to identify and resolve complex issues and/or data discrepancies that involve internal and external systems, government data, and regulatory guidance. Actively suggests analytics opportunities and best practices. Uses data mining and analytical expertise to drive business decisions and efficiencies.
• Schedules, assigns, and monitors projects, ensuring the successful development and implementation of initiatives. Provides peer review, training, and oversight. Conducts formal and informal training pertaining to new analytic approaches, data sources, and production system capabilities. May provide input in hiring, development, and performance evaluations of more junior analysts.
• Serves as an expert resource to management and other departments on VBC data and analyses. Stays current on provider contracting processes, regulations, and best practices.
• Performs other duties as assigned.

Qualifications

Senior Value-Based Contracting Data Analyst

• Bachelor’s degree in healthcare administration, business, information technology or related field.
• 5 years of experience as a Value Based Consulting Data Analyst or equivalent health care data and/or systems analysis experience in managed care, which includes provider contracting incentive programs.
• Strong knowledge of provider contracting, provider incentive programs, and related regulations, and the ability to apply to company operations.
• Knowledge of insurance concepts, plan administration, and managed care.
• Knowledge of payer performance-based contract.
• Advanced Microsoft Office (Excel, Word, Access, and PowerPoint) skills.
• Advanced SAS and/or SQL and query and report writing skills.
• Strong knowledge of business intelligence and analytical tools.

Lead Value-Based Contracting Data Analyst

• Bachelor’s degree in healthcare administration, business, information technology or related field.
• 7 years progressive experience as a Value Based Consulting Data Analyst or equivalent health care data and/or systems analysis experience in managed care, which includes provider contracting incentive programs.
• Comprehensive knowledge of provider contracting, provider incentive programs, and related regulations, and the ability to apply advanced concepts to company operations.
• Knowledge of insurance concepts, plan administration, and managed care.
• Knowledge of payer performance-based contract.
• Advanced Microsoft Office (Excel, Word, Access, and PowerPoint) skills.
• Advanced SAS and/or SQL and query and report writing skills.
• Strong knowledge of business intelligence and analytical tools.

Medical Mutual is looking to grow our team! We truly value and respect the talents and abilities of all of our employees. That's why we offer an exceptional package that includes:

A Great Place to Work:

• We will provide the equipment you need for this role, including a laptop, monitors, keyboard, mouse and headset.
• Whether you are working remote or in the office, employees have access to on-site fitness centers at many locations, or a gym membership reimbursement when there is no Medical Mutual facility available. Enjoy the use of weights, cardio machines, locker rooms, classes and more.
• On-site cafeteria, serving hot breakfast and lunch, at the Brooklyn, OH headquarters.
• Discounts at many places in and around town, just for being a Medical Mutual team member.
• The opportunity to earn cash rewards for shopping with our customers.
• Business casual attire, including jeans.

Excellent Benefits and Compensation:

• Employee bonus program.
• 401(k) with company match up to 4% and an additional company contribution.
• Health Savings Account with a company matching contribution.
• Excellent medical, dental, vision, life and disability insurance — insurance is what we do best, and we make affordable coverage for our team a priority.
• Access to an Employee Assistance Program, which includes professional counseling, personal and professional coaching, self-help resources and assistance with work/life benefits.
• Company holidays and up to 16 PTO days during the first year of employment with options to carry over unused PTO time.
• After 120 days of service, parental leave for eligible employees who become parents through maternity, paternity or adoption.

An Investment in You:

• Career development programs and classes.
• Mentoring and coaching to help you advance in your career.
• Tuition reimbursement up to $5,250 per year, the IRS maximum.
• Diverse, inclusive and welcoming culture with Business Resource Groups.

About Medical Mutual:

Medical Mutual’s status as a mutual company means we are owned by our policyholders, not stockholders, so we don’t answer to Wall Street analysts or pay dividends to investors. Instead, we focus on developing products and services that allow us to better serve our customers and the communities around us.

There’s a good chance you already know many of our Medical Mutual customers. As the official insurer of everything you love, we are trusted by businesses and nonprofit organizations throughout Ohio to provide high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans. Our plans provide peace of mind to more than 1.2 million Ohioans.

We’re not just one of the largest health insurance companies based in Ohio, we’re also the longest running. Founded in 1934, we’re proud of our rich history with the communities where we live and work.

We maintain a drug-free workplace and perform pre-employment substance abuse and nicotine testing.

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