Value- Contracting Data Analyst

Job Category: Value-Based Contracting Data Analyst

Requisition Number: VALUE
001271

• Full-Time
• Hybrid

Cleveland, OH 44144, USA

Medical Mutual employees must submit their applications through MySource.

Note:
This is a hybrid role based in Brooklyn, OH, requiring three days per week on-site.

Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.2 million members through our high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self‑funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans.

Working under general supervision, supports the operational infrastructure for the Value Based Contracting (VBC) provider incentive program. Develops and maintains internal and external data flows to optimize analytics tool (EZ Info) capabilities for value based contracting programs. Assists with managing vendor relationship.

• Compiles and maintains documentation of flows, file formats, data sources, and timing for VBC operational processes.
• Assists with managing/directing data flow between VBC vendor and the Company including updating and maintaining VBC specific files that are needed to support EZ Info reporting.
• Analyzes output and conducts quality assurance on EZ Info reports to identify opportunities for improvements.
• Assists with managing the relationship with vendor including identifying additional development needs, scoping, reviewing change orders and associated costs.
• Sets up EZ Info tool configurations – user permissions, structures, report development, automation, and exports and identifies opportunities to enhance existing capabilities.
• Collaborates with capitation payment team and sets up capitation contracts within the pricing and payment tool (EZ Cap).
• Stays current on provider contracting processes, regulations, and best practices. Collaborates with other departments to support value based contracting operations.
• Performs other duties as assigned.

Working under limited supervision, coordinates the operational infrastructure for the Value Based Contracting (VBC) provider incentive program. Develops and maintains internal and external data flows to optimize analytics tool (EZ Info) capabilities for value based contracting programs. Acts as a primary liaison with vendor. Makes recommendations on process improvement opportunities with respect to performance against Value Based Contracting goals and objectives.

• Manages/directs data flow between VBC vendor and the Company including identifying needed data, formats, fields, overseeing the accuracy of data pulls, timing, storage, and documentation.
• Manages the relationship with vendor including identifying additional development needs, scoping, reviewing change orders and associated costs.
• Supervises EZ Info tool configurations–user permissions, structures, report development, automation, and exports and recommends opportunities to enhance existing capabilities.
• Collaborates with capitation payment team and sets up capitation contracts within the pricing and payment tool (EZ Cap).
• Stays current on provider contracting processes, regulations, and best practices. Acts as a primary liaison with other departments to support value based contracting operations.
• Orients, trains, and assists more junior level Analysts.
• Performs other duties as assigned.

• Bachelor’s degree in healthcare administration, business, information technology or related field.
• 3 years of health care data and/or systems analysis experience with strong preference for managed care experience.
• Experience with provider contracting incentive programs preferred.
• Knowledge of provider contracting, provider incentive programs, and related regulations.
• Intermediate Microsoft Office (Excel, Word, Access, and PowerPoint) skills.
• Intermediate to advanced SAS and/or SQL and query and report writing skills.
• Knowledge of…