Data Consultant II or SR (DOE) at Cambia Health Solutions in Portland, OR
The Data & Process Imp Consultant II drives superior data quality through a robust process of collecting, validating, analyzing, and reporting of key information. Propels effective and efficient business operations by instituting, enhancing, and overseeing process improvement efforts. This role is critical to ensuring providers receive accurate and timely insights to effectively manage our members.
Responsibilities:
Provides data analytics, primarily for Provider Partnership Innovations (PPI) department. Pulls, validates, and analyzes data from all types of sources to identify and assess risks and prevent, detect, investigate, and correct data inconsistencies and anomalies. Develops working partnerships with data and system owners across Cambia and relevant vendors to secure necessary access, training, and context for obtaining and analyzing data Supports departmental and cross-departmental reporting, including performance reporting Develops and maintains reporting commitments Creates and manages supporting materials Analyzes and identifies healthcare industry trends and shifts in consumers' preferences, attitudes and perceptions. Researches best business practices within and outside the organization to establish benchmark data Designs, populates, maintains, and creates departmental and cross-departmental reporting, including performance reporting. Assists in analyzing monitoring results and compiling statistics on a weekly, monthly or quarterly basis. Applies data and analysis to drive process optimization, controls analysis and improvement, and risk reduction, directly and through leading cross-functional teams. Participates in remediating risk areas or identified issues and documents processes and controls; monitors and regularly reports findings. Ensures that activities are executing as planned, including vendor activities, and provides a feedback loop and remediation plan if problems are identified. Documents and reviews business requirements, internal controls and/or management controls used to generate work output. Analyzes controls for strengths and weaknesses. Provides advanced data analytics for Network Management & PPI organization. Conceptualizes solutions and develops alternatives to complex problems including anticipating upward and downward streams impacts in analysis Highly sought after by the business to provide a wide depth and breadth of consultation, education, and influence in the business. Recommends core process changes to be embedded where appropriate and contribute to incident solutions inclusive of effecting recommended training, performance coaching and other action talents essential to sustaining improved process outcomes. Explains complex processes and status updates in a manner that ensures understanding at all the leadership levels within the organization. May provide training and guidance to staff members. May assist in Product Owner responsibilities as needed. May develop and present written or oral analytic findings and recommendations to stakeholders, including senior leaders. Requirements:
Demonstrated ability in creating innovative and persuasive presentations. Ability to communicate effectively, both orally and in writing, regarding complex or sensitive information or issues. Demonstrated experience in report preparation, project documentation, or policy and procedure writing, including the ability to organize, review and interpret statistical data. Demonstrated analytical ability to identify problems, develop solutions, and implement chosen course of action. Strong computer skills including use of Microsoft Office products or equivalent software for creating and maintaining databases, spreadsheets and creating reports and documents. Action oriented with the ability to prioritize workload and focus on highest priorities. Demonstrated ability to organize, plan, prioritize and coordinate multiple projects within specified timelines with minimal supervision. A proven team player with the ability to partner, maintain and develop relationships. Ability to pull, manage, organize and analyze data Ability to understand the data and when it may be incorrect, contradictory and/or incomplete Knowledge of health insurance claims processing with the ability to pull, validate, and analyze health insurance claims data. Knowledge of health insurance data systems. May have experience in one of the following:
data mining tools (TOAD, SQL, BOE, etc.) or analytic tools, statistical analysis or methods Demonstrated ability to learn quickly when faced with new situation. Demonstrated competency in pulling, managing, organizing, and analyzing data. Demonstrated competency in reconciling data that may be incorrect, contradictory, and/or incomplete into understandable framework and actionable recommendations. Fluent with health insurance claims processing and proven ability to pull, validate, and analyze health insurance claims data. Proficient in health insurance data systems. Experienced in data mining tools (TOAD, SQL, BOE, etc.), analytic tools, statistical analysis and methods (e.g., SQL, SAS, OLAP, SPSS or the advanced statistical capabilities of Excel). Demonstrated competency in process optimization, including end-to-end process mapping, control point identification and improvement, stakeholder interviewing, and end-to-end control assessment. Proven decision making and problem solving skills. Proven influence, interpersonal, communication, and relationship-building skills. Proven ability to work as part of a team, across teams, and with key business partners at all levels of the organization. Advanced competency in pulling, managing, organzing, and analyzing data. Data expertise with Facets claims system and Facets replica preferred. Expert in data mining. Advanced competency in process utilization. Proven and thorough knowledge of business principles, theories, and concepts and deep knowledge of multiple business areas. Ability to use rigorous logic and methods to solve difficult problems with effective solutions and can see hidden problems. Solid oral and written communication skills as well as facilitation skills. Ability to connect the dots, meaning analyze information from multiple sources to determine risks and opportunities for the department. Strong interpersonal skills, ability to communicate complex ideas in clear, succinct terms; able to establish strong partnerships at various levels in the organization. Ability to train and mentor more junior consultants. Normally to be proficient in the competencies listed above:
PPI Data and Process Improvement Consultant Sr. would have a Bachelor's Degree and 8 years progressive experience in data identification, collection, validation and analytics, including report design or equivalent combination of education and related work experience. Regence employees are part of the larger Cambia family of companies, which seeks to drive innovative health solutions. We offer a competitive salary and a generous benefits package. Regence is 2.2 million members, here for our families, co-workers and neighbors, helping each other be and stay healthy and provide support in time of need. We've been here for members for 100 years. Regence is a nonprofit health care company offering individual and group medical, dental, vision and life insurance, Medicare and other government programs as well as pharmacy benefit management. We are the largest health insurer in the Northwest/Intermountain Region, serving members as Regence BlueShield of Idaho, Regence BlueCross BlueShield of Oregon, Regence BlueCross BlueShield of Utah and Regence BlueShield (in Washington). Each plan is an independent licensee of the Blue Cross and Blue Shield Association. If you're seeking a career that affects change in the health care system, consider joining our team at Cambia Health Solutions. We advocate for transforming the health care system by making health care more affordable and accessible, increasing consumers' engagement in their health care decisions, and offering a diverse range of products and services that promote the health and well-being of our members. Cambia's portfolio of companies spans health care information technology and software development; retail health care; health insurance plans that carry the Blue Cross and Blue Shield brands; pharmacy benefit management; life, disability, dental, vision and other lines of protection; alternative solutions to health care access and free-standing health and wellness solutions.
Salary Range:
$100K -- $150K
Minimum Qualification
Database AdministrationEstimated Salary: $20 to $28 per hour based on qualifications.
Responsibilities:
Provides data analytics, primarily for Provider Partnership Innovations (PPI) department. Pulls, validates, and analyzes data from all types of sources to identify and assess risks and prevent, detect, investigate, and correct data inconsistencies and anomalies. Develops working partnerships with data and system owners across Cambia and relevant vendors to secure necessary access, training, and context for obtaining and analyzing data Supports departmental and cross-departmental reporting, including performance reporting Develops and maintains reporting commitments Creates and manages supporting materials Analyzes and identifies healthcare industry trends and shifts in consumers' preferences, attitudes and perceptions. Researches best business practices within and outside the organization to establish benchmark data Designs, populates, maintains, and creates departmental and cross-departmental reporting, including performance reporting. Assists in analyzing monitoring results and compiling statistics on a weekly, monthly or quarterly basis. Applies data and analysis to drive process optimization, controls analysis and improvement, and risk reduction, directly and through leading cross-functional teams. Participates in remediating risk areas or identified issues and documents processes and controls; monitors and regularly reports findings. Ensures that activities are executing as planned, including vendor activities, and provides a feedback loop and remediation plan if problems are identified. Documents and reviews business requirements, internal controls and/or management controls used to generate work output. Analyzes controls for strengths and weaknesses. Provides advanced data analytics for Network Management & PPI organization. Conceptualizes solutions and develops alternatives to complex problems including anticipating upward and downward streams impacts in analysis Highly sought after by the business to provide a wide depth and breadth of consultation, education, and influence in the business. Recommends core process changes to be embedded where appropriate and contribute to incident solutions inclusive of effecting recommended training, performance coaching and other action talents essential to sustaining improved process outcomes. Explains complex processes and status updates in a manner that ensures understanding at all the leadership levels within the organization. May provide training and guidance to staff members. May assist in Product Owner responsibilities as needed. May develop and present written or oral analytic findings and recommendations to stakeholders, including senior leaders. Requirements:
Demonstrated ability in creating innovative and persuasive presentations. Ability to communicate effectively, both orally and in writing, regarding complex or sensitive information or issues. Demonstrated experience in report preparation, project documentation, or policy and procedure writing, including the ability to organize, review and interpret statistical data. Demonstrated analytical ability to identify problems, develop solutions, and implement chosen course of action. Strong computer skills including use of Microsoft Office products or equivalent software for creating and maintaining databases, spreadsheets and creating reports and documents. Action oriented with the ability to prioritize workload and focus on highest priorities. Demonstrated ability to organize, plan, prioritize and coordinate multiple projects within specified timelines with minimal supervision. A proven team player with the ability to partner, maintain and develop relationships. Ability to pull, manage, organize and analyze data Ability to understand the data and when it may be incorrect, contradictory and/or incomplete Knowledge of health insurance claims processing with the ability to pull, validate, and analyze health insurance claims data. Knowledge of health insurance data systems. May have experience in one of the following:
data mining tools (TOAD, SQL, BOE, etc.) or analytic tools, statistical analysis or methods Demonstrated ability to learn quickly when faced with new situation. Demonstrated competency in pulling, managing, organizing, and analyzing data. Demonstrated competency in reconciling data that may be incorrect, contradictory, and/or incomplete into understandable framework and actionable recommendations. Fluent with health insurance claims processing and proven ability to pull, validate, and analyze health insurance claims data. Proficient in health insurance data systems. Experienced in data mining tools (TOAD, SQL, BOE, etc.), analytic tools, statistical analysis and methods (e.g., SQL, SAS, OLAP, SPSS or the advanced statistical capabilities of Excel). Demonstrated competency in process optimization, including end-to-end process mapping, control point identification and improvement, stakeholder interviewing, and end-to-end control assessment. Proven decision making and problem solving skills. Proven influence, interpersonal, communication, and relationship-building skills. Proven ability to work as part of a team, across teams, and with key business partners at all levels of the organization. Advanced competency in pulling, managing, organzing, and analyzing data. Data expertise with Facets claims system and Facets replica preferred. Expert in data mining. Advanced competency in process utilization. Proven and thorough knowledge of business principles, theories, and concepts and deep knowledge of multiple business areas. Ability to use rigorous logic and methods to solve difficult problems with effective solutions and can see hidden problems. Solid oral and written communication skills as well as facilitation skills. Ability to connect the dots, meaning analyze information from multiple sources to determine risks and opportunities for the department. Strong interpersonal skills, ability to communicate complex ideas in clear, succinct terms; able to establish strong partnerships at various levels in the organization. Ability to train and mentor more junior consultants. Normally to be proficient in the competencies listed above:
PPI Data and Process Improvement Consultant Sr. would have a Bachelor's Degree and 8 years progressive experience in data identification, collection, validation and analytics, including report design or equivalent combination of education and related work experience. Regence employees are part of the larger Cambia family of companies, which seeks to drive innovative health solutions. We offer a competitive salary and a generous benefits package. Regence is 2.2 million members, here for our families, co-workers and neighbors, helping each other be and stay healthy and provide support in time of need. We've been here for members for 100 years. Regence is a nonprofit health care company offering individual and group medical, dental, vision and life insurance, Medicare and other government programs as well as pharmacy benefit management. We are the largest health insurer in the Northwest/Intermountain Region, serving members as Regence BlueShield of Idaho, Regence BlueCross BlueShield of Oregon, Regence BlueCross BlueShield of Utah and Regence BlueShield (in Washington). Each plan is an independent licensee of the Blue Cross and Blue Shield Association. If you're seeking a career that affects change in the health care system, consider joining our team at Cambia Health Solutions. We advocate for transforming the health care system by making health care more affordable and accessible, increasing consumers' engagement in their health care decisions, and offering a diverse range of products and services that promote the health and well-being of our members. Cambia's portfolio of companies spans health care information technology and software development; retail health care; health insurance plans that carry the Blue Cross and Blue Shield brands; pharmacy benefit management; life, disability, dental, vision and other lines of protection; alternative solutions to health care access and free-standing health and wellness solutions.
Salary Range:
$100K -- $150K
Minimum Qualification
Database AdministrationEstimated Salary: $20 to $28 per hour based on qualifications.
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