Manager, Business Ops Analytics

TriWest Healthcare Alliance is dedicated to serving America's heroes by connecting them to healthcare in the community. The Manager, Business Ops Analytics will oversee healthcare data reporting and analysis, managing a team of analysts to provide insights on performance metrics and support strategic initiatives for healthcare cost management.

Responsibilities:

• Act as an internal consultant to work across key stakeholders to gather data, perform analysis, and provide recommendations and insights to business leaders
• Contact center operations and metrics
• Execute business reporting functions, metric creation and reports that demonstrably drive operational actions and highlight wins / opportunities
• Interpret claim data using a variety of techniques, ranging from simple data aggregation via statistical analysis to complex data mining
• Drive improvements in cost efficiency, quality, and effectiveness of TriWest operations by performing data analysis to deliver actionable insights that are backed by empirical evidence
• Develop optimization analysis to determine how well TriWest's network meets the needs of the Government based on authorization/claims patterns, discounts achieved and access to care requirements
• Collect, compile, and analyze healthcare 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 healthcare reporting capability
• Train department staff on healthcare data querying, terminology, integrity, standards, and procedures
• Coach and mentor staff toward operational excellence and skill development
• Work with management to understand and interpret the impact of decisions made by retrieving and analyzing claims costs, authorizations and/or other relevant data. Work closely with various groups 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 system by managing automated reports
• Develop methods 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
• Perform other duties as assigned
• Regular and reliable attendance is required

Requirements:

• Bachelor's degree in Business Administration, Healthcare, Statistics, Information Management, CIS or related field or equivalent experience
• 5+ years of data analysis and reporting experience to include developing key performance indicators and providing analysis and trending
• 3+ years of experience leading and managing reporting and analytics teams
• Advanced knowledge of Business Intelligence tools (e.g. PowerBI, Tableau, SSRS)
• Excellent verbal and written communication skills and an ability to synthesize and present results in a clear and concise manner
• Demonstrated proficiency in the use of computer systems, spreadsheet applications, and data analysis software such as SQL query language, MS Excel and MS Access
• US citizenship and a favorably adjudicated DOD background investigation
• Familiar with coding methods and guidelines (CPT, ICD, HCPCS, POS, DRG, Revenue)
• 3+ years of working with call center performance data
• 1 year of experience with advanced analytics tools (e.g. Python, R)
• Masters degree in Business Administration, Statistics, Public Health or other applicable discipline
• Experience with VA healthcare, military health services system, and private Managed Care programs