Healthcare Analytics Medical Economics Manager - Medical Economics

Posting Details:

Must reside in the State ofArizona.Salary:$95,000 - $120,000Grade: 29Closing Date: Open Until FilledThis position is eligible for full-time remote work (including virtual office arrangement in Arizona).

Job Summary:

A career in public service awaits you. COME JOIN OUR TEAM!

This position manages two teams: Healthcare Analytics Medical Economics and Data Governance.

The Healthcare Analytics Medical Economics team translates Medicaid claims, encounters, membership and other data into consumable actionable insights via summaries, visualizations and recommendations. It also enables AHCCCS to make data-driven decisions to meet the AHCCCS mission of reaching across Arizona to provide comprehensive quality health care to those in need.

The Data Governance team establishes management and governance practices over the agencys data assets. This includes championing data management and best practices in the agency and representing AHCCCS at the State Data Management Steering Committee.

Major duties and responsibilities include but are not limited to:

Oversight of Healthcare Analytics Medical Economics Team, data-driven analysis and its presentation: Working with business areas to create and monitor standard reporting packages and dashboards including key performance indicators, Researching healthcare delivery topics, analyze data, and recommend solutions to address business challenges by applying knowledge of medical claims analysis, critical-thinking skills, and healthcare experience and expertise, Analyze claims, encounters, membership, and other data to identify early signs of trends or other issues related to medical care costs and quality of care, Present the results of analysis to Agency leaders and peers.

Oversight of Data Governance Team and process: Coordination of data stewardship, Responsible for agency data related documentation, Representing AHCCCS at the State Data Management Steering Committee, Ensuring that statewide policies are implemented and followed.

Manage, coach and mentor team members. Support the intake, prioritization and coordinated execution of ad-hoc analytics and data governance requests from departments across the organization.

Lead Agency initiatives, supporting staffing to deliver results across all functions within the Healthcare Analytics Medical Economics and Data Governance teams including: Develop research and analyze processes to review financial data to draw conclusions for senior leadership.

Lead efforts to educate executives, employees and customers regarding the strategic value of data and its important role as a business asset and a decision-making tool. Collaborate with line of business data owners to assess, prioritize and mitigate risks that may affect business operations and regulatory compliance resulting from data quality issues.

Establish and monitor data quality efforts and provide a central leadership for the resolution of data issues. Develop methods to monitor program or area progress and take corrective actions when necessary.

Manage and monitor multiple projects simultaneously establishing project plans and objectives to ensure goal attainment within defined parameters.

Support the development and training of team members and colleagues.

Knowledge, Skills & Abilities (KSAs):

Knowledge:

Data management concepts, practices, and procedures focusing on data governance

Healthcare data and concepts including medical and pharmacy claims, utilization management and demographic data and healthcare industry coding systems ICD-10, CPT/HCPCS, Revenue Codes, and others as applicable

Modeling of complex datasets

Data analysis and data mining

Reporting and analytics

IBM Cognos, Power BI and/or equivalent BI tools

Microsoft Excel, Word and PowerPoint

Medicaid/Medicare programs and services

PMMIS

AHCCCS business needs, operations and dependencies

Encounter processing

Skills:

Strong customer service skills

Excellent interpersonal, written & oral communication skills (verbal, written, and presentation)

Excellent problem-solving skills & attention to details

Managed Care Organization and CMS policy that relate to data governance

Abilities:

Balance, prioritize and organize multiple tasks

Work collaboratively in teams and across organizations

Synthesize feedback and adjust plans accordingly

Build strong relationships inside and outside the organization

Resolve incidents/problems efficiently and effectively, recognizing customers competence levels, and able to approach each level appropriately

Supervise small to medium teams

Understand and anticipate needs and priorities of both internal and external customers

Organize and present data in a way that facilitates inferences, conclusions and decisions

Qualifications:

Minimum:

Bachelor's degree in Mathematics, Statistics, Economics or related field plus 5 years of relevant, professional work experience (or equivalent experience). Medicaid or Medicare experience working with healthcare data including but not limited to medical claims data at a medical insurance company or equivalent at a State or Federal level for these programs. Experience querying, summarizing, and manipulating data using SQL, SAS, Python, R, Machine Learning, Cognos or PowerBI.

Preferred:

Masters degree in Mathematics, Statistics, Economics, or healthcare related discipline. Experience preparing/presenting dashboards and data using a data visualization tool such as PowerBI. Experience clearly explaining complex methodologies and present findings and recommendations to both technical and non-technical audiences.

Pre-Employment Requirements:

Successfully pass fingerprint background check, prior employment verifications and reference checks; employment is contingent upon completion of the above-mentioned process and the agencys ability to reasonably accommodate any restrictions.

Travel may be required for State business. Employees who drive on state business must complete any required driver training (see Arizona Administrative Code R2-10-207.12.)