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Sr Clinical Operations Analyst

Company: Magellan Health
Location: Cambridge
Posted on: December 9, 2018

Job Description:

Sr Clinical Operations Analyst Working closely with the leaders of our clinical and actuarial functions, the clinical operation analyst will analyze medical trends to explain financial results, develop programs for improved performance, and work to improve clinical outcomes. This position will also work cross-functionally to analyze operational work flows and develop tools to improve efficiencies throughout the organization ESSENTIAL FUNCTIONS: Analyzes business processes and assists in implementing recommendations with financial and clinical emphasis. Analyzes current clinical processes to determine areas to improve effectiveness and efficiency in accordance to SWH's care model. Collects data, performs root cause analysis, and proposes solutions for current and future needs. Collaborates with clinical and analytics teams to build operational work flows. Creates analytic views on medical expense to help management interpret historical results. Stays current on developing trend, and leverage to forecast for going forward. Explains prior performance and utilizes to forecast forward. Creates flexible clinical staffing models from work flow analysis that will allow for change in membership and clinical shift in responsibilities. Analyzes claims data to assess utilization, controlling costs, and measuring the quality of care provided as well as the efficacy of programs and initiatives. Performs budget versus actual analysis on subjects such as but not limited to: revenue, medical utilization, and membership. Ad-Hoc analytical projects. Creates user friendly tools to help measure, manage, and report the effectiveness of care management initiatives. Understands and creates documentation for clinical operational processes. Responds and communicates timely regarding deliverables. Collaborates throughout organization to maximize efficiency and effectiveness. Develops an understanding of SWH clinical and financial data to support ad-hoc analysis. Creates detailed analysis of processes and workflows to ensure ongoing improvement in key metrics General Job Information Title Sr Clinical Operations Analyst Grade 25 Job Family General Services Group Country United States of America FLSA Status United States of America (Exempt) Recruiting Start Date 7/16/2018 Date Requisition Created 7/16/2018 Minimum Qualifications Education Bachelors: Business Administration (Required), Bachelors: Computer and Information Science (Required), Bachelors: Information Technology (Required), Bachelors: Mathematics (Required), Masters License and Certifications - Required License and Certifications - Preferred Other Job Requirements Responsibilities Requires strong expertise in MS Excel and relational database such as MS Access and other database management (MS SQL) and reporting tools. Ability to use reporting software such as Actuate, Cognos, Crystal reports, SAS, or other. Ability to query the company's data warehouse and/or department systems in response to data requests.Typically 5-7 years of related analytical and/or consulting experience required, healthcare experience preferred.- Managed care experience preferred.- Database management strongly preferred. Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled

Keywords: Magellan Health, Boston , Sr Clinical Operations Analyst, Healthcare , Cambridge, Massachusetts

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