This role is critical in helping captive members manage rising healthcare costs, enhance plan efficiency, and make informed decisions about their benefits programs through data and analytics.
ESSENTIAL EDUCATION AND EXPERIENCE:
Bachelor's degree in relevant field and 5+ years previous work experience in either Client Services and/or Consulting directly with clients in the healthcare and employee benefits industries.
SKILLS/COMPETENCIES REQUIREMENTS:
- Experience in benefit solutions across different product lines and assisting with the development and implementation of Total Reward strategies for self-insured clients.
- Ability to uncover outliers and anomalies in healthcare and benefits related data and identify actionable solutions.
- Experience benchmarking healthcare and benefits related data, with a strong sense of the marketplace.
- Able to multitask, prioritize, and manage time efficiently.
- Demonstrates natural ease when dealing with clients of all levels and must be comfortable working with C-Suite stakeholders.
- Knowledge of regional marketplace and national healthcare and benefits landscape.
- Self-motivated; comfortable working independently under general direction.
- Excellent problem solving and critical thinking skills.
- Proficiency in data analysis tools (e.g., Excel, Access, SQL) and data visualization platforms (e.g., Tableau).
- Understanding of healthcare claims processing and coding systems (CPT, ICD, etc).
- Familiarity with healthcare regulations such as HIPAA.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
- Analyze healthcare claims data to identify cost drivers, potential savings, and areas for improvement in benefits programs.
- Provide insights on claims trends and performance metrics.
- Work with internal captive program teams to develop tailored reports, dashboards, and presentations that drive informed decision-making regarding healthcare spending and plan design.
- Assist in the evaluation of healthcare plans, pharmacy benefit managers, and vendors based on claims data analysis and outcomes.
- Provide support for other strategic initiatives related to healthcare benefits and cost containment efficiency.
- Analyzing and interpreting healthcare claims data (leveraging access to 3rd party data warehouse and analytic tools) to identify trends and costs drivers and assist with creating custom dashboard reporting.
- Providing actionable insights and data-driven solutions to help optimize healthcare costs and improve benefits management.
