Healthcare Analyst

The Optimal Health Collaborative unites the capabilities of one of the nation's most advanced pharmacy practices with the most experienced and proven Health and Care support services to provide the first comprehensive and integrated population health management solution for employers, health plans and government entities. Combining the capabilities of Medco and Healthways advances the ability of each organizations' healthcare professionals to reach patients sooner, with more effective information and interactions that will improve adherence with clinical practice guidelines, lower the incidence of hospitalization and increase the adoption of healthier behaviors.Job Description and Responsibilities:Working as part of a cross functional team called the Optimal Health Collaborative, the Healthcare Analyst has primary responsibility for querying and analyzing healthcare claims data and proprietary clinical information systems data to create contractually required performance metrics / reports, and ad-hoc business analyses. This position reports to the Director of Operations Finance for the Business Unit and serves customers within that Business Unit. Primary responsibilities will be as follows:* Develop, evaluate, and report key performance metrics (including financial, utilization, clinical, satisfaction, and operational) - both contractually obligated and internal / operational* Actively participate with and support the Account Team (Account Manger, Clinical Director, Finance Director) and matrix team members (e.g., IT, Product, Informatics, et. al.) with the identification and analysis of data issues in support of continuous data integrity validation and quality improvement processes. * Actively participate with - and support the Business Unit with - the identification and analysis of data issues in support of continuous data integrity validation and quality improvement processes* Actively participate with and support the Account Team (Account Manager, Finance Director, Operations) and matrix team members (e.g., IT, Product, Informatics, et. al.) with the identification and analysis of data issues in support of continuous data integrity validation and quality improvement processes. * Perform other tasks in support of specific internal/external customer requests and for the continual enhancement of the customer relationship, as required. This will include performing ad-hoc analyses, participating in project workgroups and supporting new customer account implementationsQualifications & Experience:* Must be a self-starter capable of adapting to meet fast-paced and rapidly changing business needs* Must be able to function in a highly collaborative team-oriented, results-based environment. Able to work effectively with all levels of management and demonstrate creativity, foresight, and mature judgment in anticipating and solving problems* Must demonstrate exceptional organizational skills, interpersonal and communication skills, documentation skills, and ability to manage multiple priorities* 2-4 years experience analyzing healthcare data including medical claims and eligibility, with demonstrated contemporary experience using SQL Server, PL/SQL, TOAD, Oracle, MS Access, MS Excel, and OLAP tools such as MicroStrategy* Minimum of an undergraduate degree; emphasis in finance, or information systems is preferred. Masters in health informatics or information systems a plus* Some travel will be required (10 - 20%)Healthways, a more than 26-year-old publicly traded company (NASDAQ: HWAY) based in Franklin, TN, is the nation's leading and largest provider of specialized, comprehensive disease management, care enhancement and high-risk health management services proven to improve the quality of health care for people with chronic diseases and other conditions. We work with health plans, hospitals and physicians to improve health, enhance the fundamental care experience and reduce the cost of care for over two million people nationwide.We offer our colleagues:* An energizing environment where your efforts are recognized and rewarded* Excellent salary and benefits packages, including company matched 401k, bonus potential, tuition reimbursement, HMO/PPO medical and dental plans, flexible spending plan, long-term disability, life insurance and generous paid time off!* Opportunities for growth and advancement * A nationwide network of colleagues*Please see Job Description for required skillset,analytical,claims analysis,PL/SQL,SQL,SQL Server,ToadAdditional Information: Travel Percentage: 10%