AmeriHealth Caritas Jobs

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AmeriHealth Caritas Network Report Analyst Senior in Philadelphia, Pennsylvania

Network Report Analyst Senior

Location: Philadelphia, PA

Primary Job Function: Provider Network

ID**: 21289

Your career starts now. We’re looking for the next generation of health care leaders.

At AmeriHealth Caritas, we’re passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we’d like to hear from you.

Headquartered in Philadelphia, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at www.amerihealthcaritas.com .

Responsibilities:

Reporting to the Director of CPNO Initiatives, the Sr. Network Report Analyst is responsible for extracting, manipulating, and evaluating accuracy of provider data from various sources to generate reports and to create automated reporting solutions for new and existing lines of business for all products and programs. This position is responsible for the following timely and accurate deliverables: Provider Network Adequacy Reports, Provider Directories, Provider Related Statutory Reporting, and Provider Data Cleaning Validations for new and existing lines of business, and other variable routine and ad hoc systems data pulls/analysis.

Other accountabilities:

  • Understands multiple backend provider data sources (e.g. Facets, Cactus, Contract Manager, NPPES, Enclarity, corporate vendor-obtained sources, and other External Regulatory data files) for the purposes of writing queries, developing reports as well as designing, developing, implementing and maintaining business solutions.

  • Understands existing and new business for delivering work products for RFIs, RFPs, new markets and contracts to address all network management stages and reporting requirements to demonstrate network adequacy, network gaps and solution analysis using geo-spatial tools such as GeoNetwork, Maptitude and other available resources.

  • Provide business and network analysis, summary, reports and dashboards of issues, trends, recommendations and obstacles.

  • Creates advanced reporting preparations, designs and layouts,

  • Interprets provider data using various techniques, from data aggregation to complex data mining.

  • Analyzes provider data files received from joint venture partners to evaluate issues and usefulness.

  • Coordinates with technical resources from joint venture partners and other internal resources to address and resolve data questions and anomalies.

  • Creates technical specifications for routine, recurring, and ad-hoc reports.

  • Assures the accuracy and validity of data and reports through a validation process to cross-reference output and source data; identifies provider data gaps/anomalies and provides recommended solutions to the business owner.

  • Mentors junior analysts

  • Creates automated reporting solutions for teammates, or end-user customers across the organization

  • Work collaboratively with internal customers to articulate and share results, resolutions, expectations and deliverables

Education/Experience:

  • Bachelor’s Degree required.

  • 1-3 years Provider Data knowledge preferred.

  • 5+ years’ experience in SQL programming, and other software, such as Oracle/Sybase experience required.

  • 5+ years of data analysis and data mining, including advanced, report preparation, layout and design.

  • Report writing, data analysis, data research in managed care operations.

  • Experience with databases, report preparation, layout and design.

  • Ability to plan, organize and handle multiple tasks in minimal timeframes and with limited supervision required.

  • Business process and quality improvement understanding.

  • Proficiency with Microsoft Office Suite (Word, Excel, Power Point, Access). Prior Microsoft Access experience is a requirement.

  • Experience with Sybase and Oracle database management systems and Structured Query Language (SQL) required.

  • Experience developing front-end reporting solutions, for front-end users/customers to pull reports themselves.

EOE Minorities/Females/Protected Veterans/Disabled

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