Medical Management Analyst

Summary/Position Objectives:
This position reports to the Chief Medical Officer and provides analytical support to the Medical Management department. The incumbent manages and analyzes data and document trends, and produces written reports. This person also designs, develops and supports computer information systems. Additionally, this position gathers and analyzes operational and financial information, designs and develops spreadsheet models that support written and oral presentations and reports.

Responsibilities:
Essential Functions:
Conducts quantitative and qualitative analyses on a broad array of health care issues across disciplines, projects and functional areas.
Compiles weekly status and production reports for all commercial plans, involving gathering data from QMACs as well as other sources and documents, creating a presentable format, and distributing to appropriate staff in a timely manner.
Collaborates with the staff of Medical Management and other departments to identify and investigate opportunities for development and evaluation of programs related to medical management.
Measures effects of medical service programs through:
Planning of data collection methodologies
Analyzing data
Preparing reports
Suggesting action steps based on the analytical reports
Evaluates and coordinates existing programs and services involving concurrent review, prior authorization, case management and quality management.
Evaluates and tracks the utilization and compliance of selected contracted providers.
Coordinates department preparation for external audits and accreditation surveys with reports that demonstrate outcomes that are attached to specific programs.
Designs new, and enhances existing, spreadsheet models.
Prepares written reports and PowerPoint presentations.
Monitors industry trends and regulations pertaining to Medicaid, Medicare, and Commercial health care, medical management, quality and outcomes management.
Develops, establishes, and maintains a work priority system to ensure daily workloads are fulfilled.

ABOUT SCHALLER ANDERSON:

Schaller Anderson administers Medicaid and employer self-funded health plans, and manages behavioral health plans. The company’s suite of services includes member services; provider services; claims processing; information services; financial reporting and analysis; medical management; and grievances and appeals services. Schaller Anderson has also been engaged in several consulting projects for states, health plans and providers. Schaller Anderson and its affiliates have 1,400+ employees nationwide and administer health plans with over 1.6 million members. Recently, the Initiative for a Competitive Inner City and Inc. magazine named Schaller Anderson to the Inner City 100, a list that recognizes the fastest-growing companies in America’s core urban areas. Schaller Anderson placed eighth among 5,000 entries in the Inner City 100 competition and was the only health care management company in the top 10.

The VISION of Schaller Anderson, Inc. is to be recognized as the nation’s foremost managed care resource by providing the highest value management and consulting services throughout the health care continuum.


BENEFITS:

Schaller Anderson team members are provided with countless opportunities to make a real difference and the following compensation/benefits:

* Competitive compensation DOE
* Medical, Dental and Vision insurance
* Employee Assistance Program
* Flexible spending accounts
* On-site fitness center (Phoenix headquarters only)
* Life insurance and accidental death and dismemberment insurance
* Short-term and long-term disability
* Paid holidays, paid time off/paid time off reserve
* 401(k) and profit sharing
* Tuition reimbursement
REQUIREMENTS
Knowledge and Skills:
Incumbent must be able to write correspondence and design spreadsheets; present information effectively in one-on-one and small group settings to organization employees, including company’s top management; and use advanced reasoning to define problems, collect data, establish fact, draw valid conclusions, and design, implement, and manage appropriate action plans.
Intermediate to advanced math skills, ability to work effectively with percents, ratios, etc.
The position requires the application of statistical and analytical skills, management skills, financial principles and good interpersonal communication.
Ability to perform quantitative analysis
Working knowledge of statistics
Effective analytical skills
Incumbent must have effective organization and coordination skills, and the ability to prioritize multiple tasks.
Incumbent must be proficient with Microsoft Office Suite functions, with emphasis on Excel, and common computer and office hardware.
Advanced expertise in SQL, Excel, Access, PowerPoint and windows based desktop applications
Knowledge of On-line Analytical Processing (OLAP) preferred
Knowledge of QMACS/QNXT preferred

Education and Work Experience:
Minimum of 5 years’ research and analysis experience
Minimum of 2 years’ experience in developing and working with databases
Minimum of 1 year recent and related health care-related experience
Bachelor degree in a closely-related field such as Finance, Statistics, Math, Economics, or Actuarial Science is strongly preferred, although an equivalent combination of formal education and experience may substitute for a degree
Experience in managed health care is preferred, but not required