schofield | Sr. Actuarial Analyst, Network Analytics in Sheboygan Falls, WI

Sr. Actuarial Analyst, Network Analytics

  • Ascension
  • $81,495.00 - 149,540.00 / Year *
  • N5399 Co Rd TT
  • Sheboygan Falls, WI 53085
  • Full-Time
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We Are Hiring

Senior Actuarial Analyst, Network Analytics - Acension Care Management, Actuarial & Analytics - Full-Time, Days - Glendale, WI or Nashville, TN

Why Join Ascension?

Ascension Care Management (ACM) creates customized healthcare solutions for health systems, payers, and employers that stabilize costs, improve outcomes, and enhance the experience for both providers and individuals. Our range of services strive to create a seamless healthcare experience for providers, payers and healthcare leaders by improving access to and removing complexity from the delivery of healthcare.

ACM serves 1.3 million patients across the nation and manages more than 20,000 providers through our clinically integrated networks of providers. ACM helps our customers eliminate stress and uncertainty, allowing them to confidently provide quality, value-based services and solutions. Beyond traditional population health management solutions, ACM offers additional expertise in claims management, care coordination, risk management and safety strategies that allow healthcare leaders to avoid challenges and capitalize on healthcare opportunities.

What You Will Do

The Senior Analyst - Network Analytics will support the Population Health leaders by providing analysis and data insights. Analytics will be at both a block and granular level and will be for both Commercial and Medicare populations. Analytics will be claim level and demographic analytics, across all ACM ministries.

Responsibilities:

  • Compiles analytical and statistical reports as needed.
  • Formulates, defines and recommends scope and format of reports.
  • Oversees provision of ad hoc management reports.
  • Reviews information for accuracy and reconciles data on a regular basis.
  • Book of business, network level, and market level trend analysis for Commercial and Medicare lines.
  • Transform data to analyze financial value and adequacy of our provider networks and value-based contracts within the Commercial and Medicare populations.
  • Evaluate and track medical cost initiatives on Commercial and Medicare populations.
  • Support analysis of Managed Care programs and opportunities within commercial and Medicare contracts.
  • Shared savings program analysis.
  • Competitive analysis of provider networks.

What You Will Need

Education:

  • Bachelor's degree required.
  • Bachelor's level degree in Mathematics, Computer Science, Actuarial Science or related field preferred

Work Experience:

  • Five years of experience required, preferably for a health insurance payer.
  • Strong understanding of medical claims, provider networks, enrollment and provider data preferred.

Preferred Competencies:

  • Strong technical skills, specifically in writing queries, manipulating data and visualization of data.
  • Excellent Excel and SQL skills and major plus if versatile in Tableau.
  • Demonstrated ability to find patterns of analysis and provide insights into the underlying data.
  • Ability to deliver results.
  • Deals well with ambiguity and \"start-up\" environments.
  • Excellent communication skills.

Equal Employment Opportunity

Ascension Health is an EEO/AA employer: M/F/Disabled/Vet. For further information regarding your EEO rights, click on the following link to the \"EEO is the Law\" poster:
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Please note that Ascension will make an offer of employment only to individuals who have applied for a position using our official application. Be on alert for possible fraudulent offers of employment. Ascension will not solicit money or banking information from applicants.

E-Verify Statement

Ascension Health participates in the Electronic Employment Verification Program. Please click the E-Verify link below for more information.

E -Verify (link to E-verify site)


Associated topics: actuarial, actuarial director, assistant actuary, associate actuary, cost, director actuary, life actuary, probability, retirement actuary, statistics


* The salary listed in the header is an estimate based on salary data for similar jobs in the same area. Salary or compensation data found in the job description is accurate.