BMPS Data Analyst

All Care Health Headquarters, Grants Pass, OR, US

4 days ago Requisition

Salary Range: $37.00 To $40.00 Hourly

BMPS Data Analyst at All Care Health with the Benefit Management & Pharmacy Services department in Grants Pass, Oregon

We Are Seeking Qualified Candidates to Join Our Team!

All Care Health offers competitive wages, an excellent benefits package including affordable healthcare, 401k retirement, wellness programs, and flexible schedule options.

Summary of the Position

This position is responsible for supporting multiple teams including Benefit Management & Pharmacy Services, Oral Health, Social Determinants of Health, and the medical Directors in the design, development, implementation, and coordination of complex data compilation and analysis that promotes and supports the All Care BMPS department activities by performing the following duties:

• Creates and maintains detailed listings, reporting, and data visualizations to identify cost drivers and negative trends within medical, oral health, and/or pharmacy data.
• Articulates understandable explanations of complex clinical data or trends to all staff through verbal, written, and graphical presentations.
• Designs localized utilization, case, and disease management dashboards, models, and reports to support departmental staff.
• Regularly interfaces the IT Data Science team as a product owner submitting Azure Dev Ops  Work Items (PBI’s) for the development of production Data Science PowerBI Service Dashboards.

Job Duties

• Creates, monitors, maintains, coordinates, and submits regulatorily and contractually required contract exhibit reporting to various government entities (e.g. Exhibit I, HRSN, TOC).
• Understanding, using, and incorporating clinical data derived from CCD, CCDA, and FHIR architectures.
• Extract, Transform, and Load (ETL) data from various sources.
• Creating and using queries written with SQL/T-SQL DQL (Select) Commands in SSMS.
• Work in PowerBI Desktop using PowerBI Data Marts, Symantec Models, DAX, and Power Query to create strong data visualizations.
• Use, understand, and categorize data on various healthcare code sets such as CTP, HCPCS, ICD-9/10, and HCC.
• Support the data requirements of various MA Programs.
• Create and analyze utilization across various standardized Service Categories such as indicated by the Oregon Health Grouper (OHG) for financial and other analysis.
• Integrates data from multiple reports to evaluate All Care member service utilization stratifying, prioritizing, and triaging high risk members for disease management and case coordination.
• Assists with collection and interpretation of risk stratification data for All Care Medicaid and Medicare members.
• Works with department staff and IT to collect and interpret REALD & SOGI data to help identify any care gaps or barriers within our member populations.
• Assists the Benefit Management & Pharmacy Services department with assessing utilization trends to identify ways to automate prior authorization processes whenever possible.
• Runs weekly, monthly, and quarterly reports to highlight current utilization and cost data for department leadership.
• Prepares for and participates in all required DSNP training and education.
• Maintains punctual, regular and predictable attendance.
• Works collaboratively in a team environment with a spirit of cooperation.
• Respectfully takes direction from leadership.
• Meets all required training including those listed in Relias Learning Module System (LMS).
• Performs other duties as assigned.

On Call Responsibilities

This position does not have any on call responsibilities.

Supervisory Responsibilities

This position does not have any supervisory responsibilities.

Qualifications

Ability to perform essential job duties with or without reasonable accommodation and without posing a direct threat to safety or health of employee or others. To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential duties.

Being bilingual in another…