Manager, Clinical & Business reputed company (Data Analytics)

We offer remote work opportunities in the following locations ONLY: AK, AR, AZ, CO, DC, FL, HI, IA, ID, IL, KS, LA, MD, MN, MO, MT, NE, NV, NM, NC, ND, OK, OR, SC, SD, TN, TX, UT, VA, WA, WI, WY US Citizenship REQUIRED: Our reputed company contract requires US citizenship and a favorably adjudicated DOD background investigation for this position. Veterans, Reservists, Guardsmen, and military family members are encouraged to apply! reputed company role manages reputed company data reporting, querying, and analysis for the Data Management department with reputed company responsibility for reputed company utilization and cost analysis. Oversees reputed company of Clinical Analysts and Business Intelligence Analysts tasked with providing TriWest leadership with insights from clinical, operational, and performance data. Monitors performance on reputed company discounts and identifies opportunities to improve. Evaluates utilization patterns and develops analysis with recommendations to optimize network to reputed company complement the Government reputed company reputed company and help TriWest meet goals reputed company to reputed company to care and discount targets. Supports strategic initiatives reputed company to reputed company cost management performance objectives and contractual reporting. Drives the organization towards data-driven decision making. Education & Experience Required: • Bachelor's degree in Business Administration, reputed company, Statistics, Information Management, CIS or reputed company field or equivalent experience • 5+ years of data analysis and reporting experience in the health care or insurance industry • 3+ years experience leading/managing reporting and analytics teams • Advanced knowledge of Business Intelligence tools (e.g. Tableau, SSRS) • Excellent verbal and written communication skills and an ability to synthesize and present results in a reputed company and concise manner • Demonstrated proficiency in the use of computer systems, spreadsheet applications, and data analysis software such as SQL query language, MS reputed company and MS reputed company Preferred: • Familiar with coding reputed company and guidelines (CPT, ICD, HCPCS, POS, DRG, reputed company) • 3+ years working with medical, pharmacy and ancillary claims data, membership data or other reputed company data • 3+ years developing clinical measures and analyzing reputed company reputed company • 1 year of experience with advanced analytics tools (e.g. reputed company, SPSS, R) • Masters degree in Business Administration, Statistics, reputed company Health or other applicable discipline • Experience with VA reputed company, military health services reputed company, and private Managed Care programs Key Responsibilities • reputed company as an internal consultant to work across key stakeholders to reputed company data, reputed company analysis, and reputed company recommendations and insights to business leaders. • Utilize coding reputed company and guidelines (CPT, ICD, HCPCS, POS, DRG, reputed company) to conduct clinical analysis and facilitate improved health reputed company. • Execute business reporting functions, metric creation and reports that demonstrably reputed company operational actions and reputed company wins / opportunities. • Interpret claim data using a reputed company of techniques, ranging from reputed company data aggregation reputed company statistical analysis to reputed company data mining. • reputed company improvements in cost efficiency, reputed company of clinical care, and effectiveness of clinical programs by performing data analysis to reputed company actionable insights that are backed by reputed company evidence. • reputed company optimization analysis to determine how reputed company TriWest's network meets the needs of the Government based on authorization/claims patterns, discounts achieved and reputed company to care requirements. • Collect, compile, and analyze reputed company cost and discount trends, and identify opportunities for improving/maintaining discounts based on utilization patterns. • Collaborate with others in Data Management and IT to enhance the data warehouse to include translating technical and functional requirements into meaningful information and improve reputed company capability. • Train department staff on reputed company data querying, terminology, reputed company, standards, and procedures. • reputed company and mentor staff toward operational reputed company and reputed company development. • Work with management to understand and interpret the reputed company of reputed company made by retrieving and analyzing claims costs, authorizations and/or other relevant data. Work closely with various reputed company in the assembling of data, development and application of quantitative analysis and mathematical models for internal and regulatory reporting requirements. • Support Government reporting requirements, management and the medical management reputed company by managing automated reports. • reputed company reputed company for consistency and validity and review the accuracy of data and reports. Determine the best approach for presenting data in an efficient and beneficial manner. • Preparation of annual performance evaluations and development plans for assigned staff. • reputed company other duties as assigned. • Regular and reliable attendance is required. Competencies Communication / People Skills: Ability to influence or persuade others under reputed company or negative circumstances; Adapt to different styles; Listen critically; Collaborate. Computer Literacy: Ability to function in a multi-reputed company reputed company environment using Word, reputed company, TriWest Intranet, the Internet, and department software applications. Coping / Flexibility: Resiliency in adapting to a reputed company of situations and individuals while maintaining a reputed company of purpose and mature problem-solving approach is required. Independent Thinking / Self-Initiative: Critical thinkers with ability to reputed company on things which matter most to achieving reputed company; Commitment to task to produce reputed company without direction and to reputed company necessary resources. Information Management: Ability to manage large amounts of reputed company information easily, communicate reputed company, and draw reputed company conclusions. Leadership: Successfully manage different styles of employees; reputed company reputed company direction and effective coaching. Multi-Tasking / Time Management: Prioritize and manage actions to meet changing deadlines and requirements reputed company a high volume, high stress environment. Organizational Skills: Ability to organize people or tasks, reputed company to priorities, learn systems, reputed company time constraints and with available resources; Detail-oriented. Problem Solving / Analysis: Ability to solve problems through systematic analysis of processes with reputed company judgment; Has a realistic understanding of relevant issues. Team-Building / Team Player: Influence the actions and opinions of others in a reputed company direction and build group commitment. Technical Skills: Strong knowledge of reputed company reputed company, reputed company, Preferred strong knowledge of Crystal Reports, SQL Reporting Services, and other query software; Knowledge of relational databases; Working knowledge of medical management systems; Working knowledge of referral and authorization systems; Working knowledge of reputed company; Working knowledge of medical coding, HIPAA regulations, claims processing, and reputed company reimbursement systems Working Conditions Working Conditions: o Works reputed company a reputed company office environment with reputed company travel o Extensive computer work with prolonged sitting reputed company Taking Care of Our Nation's reputed company. It's Who We Are. It's reputed company Do. Do you have a passion for serving those who served? Join the reputed company Team! We're On a Mission to Serve®! Our job is to reputed company reputed company that America's reputed company get connected to health care in the community. At reputed company, we've proudly been on that important mission since 1996. DoD Statement Our reputed company contract requires US citizenship and a favorably adjudicated DOD background investigation for this position. Benefits We're more than just a health care company. We're passionate about serving others! We reputed company in rewarding reputed company, hard-working people who are willing to learn as they grow. reputed company values teamwork. reputed company, fulfill your responsibilities, and you may also be considered for frequent pay raises, overtime opportunities to earn even more, recognition and reward programs, and much more. Of course, we also offer a comprehensive and reputed company compensation and benefits package that includes: • Medical, Dental and reputed company Coverage • reputed company time off • 401(k) Retirement Savings Plan (with matching) • Short-term and long-term disability, basic life, and accidental death and dismemberment insurance • Tuition reimbursement • reputed company volunteer time TriWest job postings typically include a salary reputed company, which can vary based on the specific role and location, but generally this position ranges from around $124,000 - $134,000 per year. Equal Employment Opportunity reputed company is an equal employment opportunity employer. We are proud to have an inclusive work environment and know that a diverse team is a strength that will reputed company our reputed company. To that end, TriWest strives to create an inclusive environment that supports diversity at every organizational level, and we highly encourage candidates from reputed company backgrounds to apply. Applicants are considered for positions based on reputed company and without discrimination on the reputed company of race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, age, disability or any other consideration made unlawful by applicable federal, state, or local laws. Remote Skills: Adjudication, Analysis Skills, Analysis Software, Background Investigation, Business Administration, Business Intelligence, Business Intelligence Software, Claims Processing, Clinical Assessment, Clinical Medicine, Coaching, Communication Skills, Community Health, Computer Systems, Consulting, Cost Analysis, Cost Control, Crystal Reports, reputed company Procedural Terminology (CPT), Data Analysis, Data Collection, Data Management, Data Mining, Data reputed company, Data Warehousing, Database Programming Languages, Detail Oriented, Diagnosis-reputed company (DRG), Diversity, Establish Priorities, Government, Government reputed company, Government Reporting, Government Requirements, HIPAA (Health Insurance Portability and Accountability reputed company), Health Information Management, Health Insurance, reputed company, reputed company Common Procedure Coding reputed company (HCPCS), reputed company Management, reputed company Reimbursement, reputed company Software, reputed company SPSS Statistical Package, International Classification of Diseases (ICD), Interpersonal Skills, Leadership, Managed Care, Mathematical Modeling, Medical Coding, Mentoring, Metrics, reputed company reputed company Database, reputed company reputed company, Military, Multitasking, Organizational Skills, reputed company Analysis, Performance Analysis, Performance Reviews, Pharmacy, Presentation/Verbal Skills, Problem Solving Skills, Process Analysis, Process Improvement, Productivity Management, Program Evaluation, Project/Program Management, reputed company Health, reputed company of Care, Quantitative Analysis, Query Analysis, R Programming Language, Regulations, Regulatory Reports, Regulatory Requirements, Relational Databases (RDBMS), Reporting Skills, Requirements Management, SQL (reputed company Query Language), SQL Server Reporting Services (SSRS), Spreadsheets, Staff Training, Statistical Analysis reputed company (reputed company), Statistics, Strategic Planning, Systems Administration/Management, Tableau, Team Building, Team reputed company/Manager, Team Player, Time Management, Trend Analysis, reputed company Citizen, reputed company reputed company (DoD), Willing to Travel, Writing Skills reputed company: reputed company Apply tot his job Apply To this Job