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Manager, Medical Economics

HealthHelp

This is a Full-time position in Houston, TX posted May 14, 2021.

Company Description

HealthHelp – A WNS Company (www.HealthHelp.com), is the leader in the field of healthcare utilization & care management. We have gained this position by actively working to change out-of-date practices with a collaborative, non-denial based approach. Our methodology helps payors achieve a higher return on investment, gives providers education programs that better inform physicians, and ensures quality and safety for the patients needing treatment.

HealthHelp’s innovative approach and strong IT capability in specialty benefits management means that staff will move healthcare forward when provided with evidence-based solutions and second opinions. HealthHelp’s staff is comprised of healthcare professionals who make a difference every day. HealthHelp has a desire to fill their company with talented and innovative people who want a career path filled with success and personal growth.

Our specialty benefits management services are broad and include, Cardiology, Oncology, Radiology, Radiation Therapy, Sleep Care, and Musculoskeletal Care. HealthHelp has two locations in Houston, one a corporate office and the second a state-of-the art contact center. HealthHelp is also proud to have another such contact center in Albany, New York.

WNS Global Services Inc. (NYSE: WNS) is a global Business Process Management (BPM) leader. WNS offers business value to 400+global clients by combining operational excellence with deep domain expertise in key industry verticals, including Banking and Financial Services, Consulting and Professional Services, Healthcare, Insurance, Manufacturing, Retail and Consumer Packaged Goods, Shipping and Logistics, Telecommunications, Travel and Utilities. Globally, the group’s over 44,000+ Professionals serve across 60 delivery centers in 16 countries worldwide.

Job Description

SUMMARY

This position is responsible for directing and supporting business analysis, utilization analysis, quality metrics reporting and performance results monitoring. The incumbent will also support reports design, development and standardization, data quality issues research/resolution and analytical support within the Medical Economics and Informatics (MEI) Department.

 

MAJOR RESPONSIBILITIES

 

•         Lead a team of analysts to execute complex modeling and data requirements producing sound, comprehensive economic analysis that provides value and fulfills the client’s needs

•         Ensure team provides timely and accurate ad hoc analyses to internal and external customers

•         Collaborates on identifying trends/opportunities in unmanaged and managed populations and work with the Analytics Executives on analyzing findings

•         Assess and analyzes internal customer requirements and needs related to healthcare quality, cost and provider performance. Provides support for reporting as needed.

•         Coordinates analysis and report development for specific programs in order to help monitor and report on program level results, savings and performance metrics to be shared with internal Program Management team.

•         Reviews and collaborates on updating of program level operational reporting (Development & Implementation) on program performance (results and operational metrics) to help improve efficiency and usability of reports.

•         Contributes to standardization of reports and new metrics development in conjunction with Program Management team to facilitate program level reporting for both internal and external use

  • Collaborates with Program Managers to identify and resolve data quality issues related to reporting

•         Contribute in development, maintenance and monitoring of savings methodologies for existing  programs and new programs

•         Collaborates in metric logics, definitions and develops reports on quality metrics for specific programs to help monitor and report on program level results to be shared with internal and/or external stakeholders

•         Responsible for ad-hoc Program/Products/Quality requests and Trend Benders analysis

•         Provide guidance, quality assurance review and support to Reporting Analysts.

•         Collaborates with Reporting Analyst(s) and Reporting Manager(s) to improve outputs efficiency and accuracy of deliverables.

•         Collaborate with MEI team members on special projects and peer review of requests.

•         Collaborate with MEI team members on finding efficiency/accuracy solutions that can be implemented to improve reporting outputs and processes.

Qualifications

QUALIFICATIONS & REQUIREMENTS

•         Bachelor Degree or higher in Healthcare Informatics, Health Care Statistics, Public Health Economics, Epidemiology, Mathematics, Computer Science/IT, related field or equivalent experience. 

  • Minimum of five (5) years of direct experience in Healthcare analytics using Medical Claims and healthcare records. 
  • Minimum two (2) years of managing an analytics team with demonstrated success, preferably healthcare, or equivalent experience.
  • Direct and significant experience in  business intelligence applications and/or statistical analysis software including SQL/MySQL/R, SAS,  Tableau, Minitab, Matlab, Crystal Reports, Business Objects Desktop(Web based) Intelligence.
  • Substantial knowledge of database structures, data querying, distributed computing tools, data mining/auditing and technical documentation preferred.
  • Intermediate to advanced skills with Microsoft Office tools (MS Word, Excel, PowerPoint, Visio, Project) necessary to document, track and present information related to company program/products/clients

•         Knowledge of healthcare financial business cycle, healthcare quality reporting and analysis, benchmarking is required

  • Knowledge of health system functions, terminology and standard diagnosis and procedure coding systems is required.
  • Proven ability to establish and articulate a vision, set goals, develop and execute strategies, and track and measure results.
  • Ability to create and foster a cooperative team work environment.
  • Excellent critical and analytical thinking skills, interpersonal and written communication skills.

•         Aptitude to effectively communicate analytical findings and conclusions to internal stakeholders and/or key business leaders.

  • Proven ability to complete projects and achieve results in an ambiguous work environment.

•         Attention to detail, effective time manager and multitasking skills are highly desirable

•         Ability to manage responsibilities (with minimal supervision) and exercise initiative

Additional Information

All your information will be kept confidential according to EEO guidelines.

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