Description
Medical Mutual employees must submit their applications through MySource.
Note: This is a hybrid role based in Brooklyn, OH, requiring three days per week on-site.
Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.2 million members through our high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. Value-Based Contracting Data Analyst Job Summary:Working under general supervision, supports the operational infrastructure for the Value Based Contracting (VBC) provider incentive program. Develops and maintains internal and external data flows to optimize analytics tool (EZ Info) capabilities for value based contracting programs. Assists with managing vendor relationship.
Responsibilities:
- Compiles and maintains documentation of flows, file formats, data sources, and timing for VBC operational processes.
- Assists with managing/directing data flow between VBC vendor and the Company including updating and maintaining VBC specific files that are needed to support EZ Info reporting.
- Analyzes output and conducts quality assurance on EZ Info reports to identify opportunities for improvements.
- Assists with managing the relationship with vendor including identifying additional development needs, scoping, reviewing change orders and associated costs.
- Sets up EZ Info tool configurations – user permissions, structures, report development, automation, and exports and identifies opportunities to enhance existing capabilities.
- Collaborates with capitation payment team and sets up capitation contracts within the pricing and payment tool (EZ Cap).
- Stays current on provider contracting processes, regulations, and best practices. Collaborates with other departments to support value based contracting operations.
- Performs other duties as assigned.
Senior Value-Based Contracting Data Analyst
Job Summary:
Working under limited supervision, coordinates the operational infrastructure for the Value Based Contracting (VBC) provider incentive program. Develops and maintains internal and external data flows to optimize analytics tool (EZ Info) capabilities for value based contracting programs. Acts as a primary liaison with vendor. Makes recommendations on process improvement opportunities with respect to performance against Value Based Contracting goals and objectives.
Responsibilities:
- Manages/directs data flow between VBC vendor and the Company including identifying needed data, formats, fields, overseeing the accuracy of data pulls, timing, storge, and documentation.
- Manages the relationship with vendor including identifying additional development needs, scoping, reviewing change orders and associated costs.
- Supervises EZ Info tool configurations–user permissions, structures, report development, automation, and exports and recommends opportunities to enhance existing capabilities.
- Collaborates with capitation payment team and sets up capitation contracts within the pricing and payment tool (EZ Cap).
- Stays current on provider contracting processes, regulations, and best practices. Acts as a primary liaison with other departments to support value based contracting operations.
- Orients, trains, and assists more junior level Analysts.
- Performs other duties as assigned.
Qualifications:
Value-Based Contracting Data Analyst
- Bachelor's degree in healthcare administration, business, information technology or related field.
- 3 years of health care data and/or systems analysis experience with strong preference for managed care experience.
- Experience with provider contracting incentive programs preferred.
- Knowledge of provider contracting, provider incentive programs, and related regulations.
- Intermediate Microsoft Office (Excel, Word, Access, and PowerPoint) skills.
- Intermediate to advanced SAS and/or SQL and query and report writing skills.
- Knowledge of business intelligence and analytical tools.
Senior Value-Based Contracting Data Analyst
- Bachelor's degree in healthcare administration, business, information technology or related field.
- 5 years of experience as a Value Based Consulting Data Analyst or equivalent health care data and/or systems analysis experience in managed care, which includes provider contracting incentive programs.
- Strong knowledge of provider contracting, provider incentive programs, and related regulations, and the ability to apply to company operations.
- Knowledge of insurance concepts, plan administration, and managed care.
- Knowledge of payer performance-based contract.
- Advanced Microsoft Office (Excel, Word, Access, and PowerPoint) skills.
- Advanced SAS and/or SQL and query and report writing skills.
- Strong knowledge of business intelligence and analytical tools.
Medical Mutual is looking to grow our team! We truly value and respect the talents and abilities of all of our employees. That's why we offer an exceptional package that includes:
A Great Place to Work:
- We will provide the equipment you need for this role, including a laptop, monitors, keyboard, mouse and headset.
- Whether you are working remote or in the office, employees have access to on-site fitness centers at many locations, or a gym membership reimbursement when there is no Medical Mutual facility available. Enjoy the use of weights, cardio machines, locker rooms, classes and more.
- On-site cafeteria, serving hot breakfast and lunch, at the Brooklyn, OH headquarters.
- Discounts at many places in and around town, just for being a Medical Mutual team member.
- The opportunity to earn cash rewards for shopping with our customers.
- Business casual attire, including jeans.
Excellent Benefits and Compensation:
- Employee bonus program.
- 401(k) with company match up to 4% and an additional company contribution.
- Health Savings Account with a company matching contribution.
- Excellent medical, dental, vision, life and disability insurance — insurance is what we do best, and we make affordable coverage for our team a priority.
- Access to an Employee Assistance Program, which includes professional counseling, personal and professional coaching, self-help resources and assistance with work/life benefits.
- Company holidays and up to 16 PTO days during the first year of employment with options to carry over unused PTO time.
- After 120 days of service, parental leave for eligible employees who become parents through maternity, paternity or adoption.
An Investment in You:
- Career development programs and classes.
- Mentoring and coaching to help you advance in your career.
- Tuition reimbursement up to $5,250 per year, the IRS maximum.
- Diverse, inclusive and welcoming culture with Business Resource Groups.
About Medical Mutual:
Medical Mutual's status as a mutual company means we are owned by our policyholders, not stockholders, so we don't answer to Wall Street analysts or pay dividends to investors. Instead, we focus on developing products and services that allow us to better serve our customers and the communities around us.
There's a good chance you already know many of our Medical Mutual customers. As the official insurer of everything you love, we are trusted by businesses and nonprofit organizations throughout Ohio to provide high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans. Our plans provide peace of mind to more than 1.2 million Ohioans.
We're not just one of the largest health insurance companies based in Ohio; we're also the longest running. Founded in 1934, we're proud of our rich history with the communities where we live and work.
We maintain a drug-free workplace and perform pre-employment substance abuse and nicotine testing.
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