Director - Payer Analytics

Overview

At SCA Health, we believe health care is about people - the patients we serve, the physicians we support and the teammates who push us forward. Behind every successful facility, procedure or innovation is a team of 15,000+ professionals working together, learning from each other and living out the mission, vision and values that define our organization.

As part of Optum, SCA Health is redefining specialty care by developing more accessible, patient-centered practice solutions for a network of more than 370 ambulatory surgical centers, over 400 specialty physician practice clinics and numerous labs and surgical hospitals. Our work spans a broad spectrum of services, all designed to support physicians, health systems and employers in delivering efficient, value-based care to patients without compromising quality or autonomy.

What sets SCA Health apart isn't just what we do, it's how we do it. Each decision we make is rooted in seven core values:

• Clinical quality
• Integrity
• Service excellence
• Teamwork
• Accountability
• Continuous improvement
• Inclusion

Our values aren't empty words - they inform our attitudes, actions and culture. At SCA Health, your work directly impacts patients, physicians and communities. Here, you'll find opportunities to build your career alongside a team that values your expertise, invests in your success, and shares a common mission to care for patients, serve physicians and improve health care in America.

At SCA Health, we offer a comprehensive benefits package to support your health, well-being, and financial future. Our offerings include medical, dental, and vision coverage, 401k plan with company match, paid time off, life and disability insurance, and more. Please visit, https://careers.sca.health/why-sca, to learn more about our benefits.

Your ideas should inspire change. If you join our team, they will.

Responsibilities

SCA Health is currently seeking a Data & Analytics Director with healthcare claims and data analytics experience to support our Health Innovation Value Enterprise (HiVE) Team. The HiVE is the evolution of SCAH's specialist partnership vision that aims to realize a sustainable value-based care solution. Through joint venture partnerships, the HiVE creates risk bearing entities driven by a global risk, specialty focused payment model.

We are seeking a candidate who is excited to take a thoughtful approach to examine and organize complex datasets into meaningful output. Moreover, we are seeking an analyst with an investigative mindset to explore nuances of the data and use data to drive strategy and decisions through report preparation and analysis. This position will report to the Senior Director of Strategic Analytics.

This position will be remote.

Responsibilities:

• Provide data support in the development and performance of specialty focused innovative strategies and risk-based arrangements

• Evaluate, organize & analyze large claims data sets to perform studies on pricing, utilization, and health care costs for a broad range of specialty healthcare services

• Develop scalable processes and best practices to ensure consistent and accurate methodologies and approaches when analyzing large data sets

• Interpret, compile, and disseminate results of analyses with appropriate conclusions and recommendations to assist in team decision making and strategic direction

• Support cross-functional team members with development, implementation, and maintenance of risk-based opportunity and performance reporting

• Retrieve, organize, and manipulate data from internal Enterprise Data Warehouse

• Understand and become an expert on the structure and intricacies of incoming data from external sources

• Collaborate with other SCAH and Optum business units to enhance and process data as needed

• Present ideas and participate in meetings - Actively seek new opportunities to contribute

• Mentor junior analysts and review deliverables as needed

• Uphold and practice the principles and policies of the SCA Compliance program

Qualifications

• Bachelor's degree in Actuarial Science, Mathematics, Statistics, Economics, or related field

• 5+ years analytical experience, or 3+ years analytical experience in a Healthcare/Managed Care environment required (i.e. understanding of costs, expected claims, diagnosis codes, procedure codes)

• Experience in hospital, health plan, risk-based care delivery organizations or physician claims analytics preferred

• Experience with managed care contract terms

• Strong written and verbal communication skills and experience collaborating with cross-functional partners and presenting analytical findings to non-analytical audiences and stakeholders

• Proven intellectual curiosity and drive to serve teammates and partners

• Superior analytical and critical thinking skills with exceptional attention to detail

• Ability to travel 5-10% of the time to team, partner, and health plan meetings

• Advanced proficiency in MS Excel

• MS SQL Server (Strong command over T-SQL) required

• Proficiency with Tableau Desktop, or similar visual analytics platform preferred

USD $125,000.00/Yr. USD $150,000.00/Yr.