Data Analyst - Utilization Management

Nov 16 2020
Full Time

A bit about us: 

We’re on a mission to change healthcare — how it’s paid for, delivered, experienced. We want to put people center stage, not process or profit. We are guided by a deep belief that every person on Medicare should be treated like we would treat a member of our own family: with loving care and a profound commitment to their health and well-being. 

That’s why we’re gathering a whole bunch of smart, big-hearted people to create a new kind of healthcare company — one that combines compassion, health insurance, clinical care, and technology seamlessly. 

We want to throw the long ball with people we love for a cause we believe in. Life is short. Join us.

Why Devoted:
Make a difference... a big difference. You will have the opportunity, in a unique and dynamic culture, to be a part of something incredibly meaningful. We’re a disruptive startup with an inspiring mission. Learn and grow alongside our world-class team of healthcare, technology, and data leaders, dedicated to building a health plan and clinical services that care for everyone like they were members of our own family. Our team and board members have decades of experience in health care entrepreneurship, data, technology, services, and policy. With their support, we are building a health plan and clinical services that will give seniors easy access to the high-quality care they deserve.

A bit more about this role:
As the Utilization Management (UM) Data Analyst you will develop and manage strategic initiatives that will provide analytics which shed insight into all aspects of UM Operations. You will develop and propose analytics-based recommendations for improving financial performance, operating performance, and the customer experience. You will generate detailed reports and analysis to ensure compliance with regulatory requirements and internal processes. The Analyst will identify inefficiencies and implement process improvements, provide guidance and support toward resolution of UM-related issues with an emphasis on root cause analysis and resolution of problems.

Responsibilities will include:

  • Serves as the UM data expert for the organization
  • Uses SQL coding to pull UM and other healthcare data to support healthcare analytics.
  • Supports the development of effective medical management programs/initiatives through analyzing, monitoring, and reporting the effectiveness of these programs.
  • Develops and implements plans to measure and report on corporate-wide health care delivery cost and utilization trends.
  • Responsible for ad hoc analytics including modeling scenarios to support medical and payment policy initiatives
  • Creates and presents analyses of complex data projects explaining trends and areas of opportunity 
  • Assists in providing insight on underlying business issues and healthcare cost drivers
  • Leads analytical projects by coordinating all stages of the development life cycle
  • Facilitates workgroup sessions, applies business experience and analytical skills to define recommendations and improve processes
  • Responsible for project deliverables by developing project and communication plans, risk analysis, schedules along with other project management deliverables while consistently reporting status to management

Attributes to success:

  • Excited by building new things 
  • Curiosity and willingness to ask questions
  • A deep desire to improve and make a change in the healthcare experience
  • Preference towards collaboration and preventing silos
  • You will roll up your sleeves and do whatever it takes to get the job done
  • Ability to move fast and get things done

Desired skills and experience:

  • Bachelor’s degree, MBA preferred with 5 years of experience in Healthcare, Consulting, or General Management or equivalent combination of education and experience
  • 7 years related experience in UM and/or Appeals and Grievances (A&G) data modeling and analysis with demonstrated ability to independently draw inferences and to communicate findings.
  • A background in managed healthcare, insurance operations a must, Medicare operations preferred 
  • Expert understanding and user of UM and/or A&G data
  • Ability to meet deadlines, multi-task, problem solve and use appropriate technology to analyze business problems
  • Strong communication skills, both verbal and written, are required

Healthcare equality is at the center of Devoted’s mission to treat our members like family. We are committed to a diverse and vibrant workforce. If you lack a specific credential for this position but believe that your strengths and life experiences will propel our mission, we would love to hear from you.

If you love running towards complex challenges and transforming them into solutions, if you want to make a potentially huge impact on many lives, and if you are looking for a disruptive startup with an inspiring and talented team, Devoted Health may be the place for you! 

Devoted is an equal opportunity employer.  We are committed to a safe and supportive work environment in which all employees have the opportunity to participate and contribute to the success of the business. We value diversity and collaboration. Individuals are respected for their skills, experience, and unique perspectives. This commitment is embodied in Devoted’s Code of Conduct, our company values and the way we do business.

As an Equal Opportunity Employer, the Company does not discriminate on the basis of race, color, religion, sex, pregnancy status, marital status, national origin, disability, age, sexual orientation, veteran status, genetic information, gender identity, gender expression, or any other factor prohibited by law. Our management team is dedicated to this policy with respect to recruitment, hiring, placement, promotion, transfer, training, compensation, benefits, employee activities and general treatment during employment.
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