Director, Analytics - 151752
Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 Members with the following programs:
• Medicaid State of Texas Access Reform (STAR) program for low-income children and pregnant women
• Children’s Health Insurance Program (CHIP) for the children of low-income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR
• Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre-existing conditions.
Improving Members' experiences is at the heart of every Community position. We strive every day to make sure that our Members have access to the high-quality health care they need and deserve.
Community is accredited by URAC for its health plan operations. We offer care management programs for asthma, diabetes, and high-risk pregnancy. An affiliate of the Harris Health System (Harris Health), Community is financially self-sufficient and receives no financial support from Harris Health or from Harris County taxpayers.
The Director, Analytics provides leadership and direction for the development and implementation of Community Health Choice's analytical reporting tools, data analysts and analytic services for the entire company. This position is responsible for collection, aggregation, analysis and presentation of decision support tools for Community Leadership. Collaborates with all departments, including Finance, IT, Operations, Medical Affairs and Network Management, from a strategic perspective to identify and maximize opportunities to utilize data to improve clinical outcomes, business processes, promote the strategic use of information, and enable the workforce to use data analysis and interpretation as a competitive tool. Responsible for State of Texas external deliverables and to audit claim payments to review compliance with contracts and Identify financial opportunities.
- Bachelor's degree in technical, mathematics, research, analytical field or other related field.
- Master's preferred.
- Seven years of experience in business performance reporting, data analysis and proactive insights.
- Managed Care and Medical claims experience preferred.
- Three years of directly leading and managing teams.
- knowledge of medical terminology and coding, HMO concepts, practices and procedures, as well as financial concepts and statistical analysis.
- advanced technical skills in computer programming, database concepts, statistics and ad hoc query tools (i.e. SQL, SAS, MS Access, Excel, etc.) as well as design expertise in visual analytics.
- Must be able to meet deadlines, juggle multiple projects and work independently.
- Knowledge of healthcare analytics
- Aptitude in telling the story behind the data and translating analysis into insights and recommendations
- Familiarity with medical coding, utilization trends and healthcare finance.
- Strong analytical skills and business problem-solving skills.
- Expertise with SQL, SAS, PowerBI, Excel, Access or other report databases
- Excellent communication, planning, and organizational skills
- Executive presence with excellent written and oral communication skills
Benefits and EEOC
Community employees’ benefits are provided by Harris Health. These benefits are designed to provide you with flexibility and choices in meeting your specific needs.
Community is an Equal Opportunity Employer.