Summer Intern - MLTC+ MAP Risk Analyst

Empower. Unite. Care.

MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.

About NYC Health Hospitals

MetroPlusHealth provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health Hospitals, the largest public health system in the United States, MetroPlusHealth network includes over 27,000 primary care providers, specialists and participating clinics. For more than 30 years, MetroPlusHealth has been committed to building strong relationships with its members and providers.

Position Overview

The purpose of this position to MetroPlusHealth is to utilize the insurance plan’s data to provide analysis and curated data extracts related to the provision of health care reporting as it pertains to the financial, contracting, quality, and reporting of health care services rendered. The position is also responsible for research collection, analysis and presentation of the Plan’s utilization, quality and claims data. Candidates interested must work alongside multiple departments within the Plan in an effort to coordinate analytics to enhance operational efficiencies and data accuracy. The summer intern analyst will work with internal and external stakeholders in quantifying and analyzing risk results and practice patterns to explain and financial performance and key drivers.

Duties & Responsibilities

• Execute, deliver, and maintain established scheduled reporting processes.
• Collaborate with Care Management Associate leadership to review and analyze a variety of analytics outputs, including system, claims, and authorization data reports.
• Support the preparation and delivery of data for incorporation into existing reporting frameworks.
• Collect, organize, and store data provided by external departments and actuaries to enable downstream reporting.
• Ingest, format, and archive information received from external departments and actuaries for integration into downstream reporting systems.
• Develop, update, and maintain documentation for processes that impact key business workflows across departments, providing guidance to staff and identifying opportunities for improvement or enhanced knowledge.
• Prepare projection analyses of claims and utilization, including trend assessment and risk evaluation.
• Conduct claims analyses of required providers based on risk performance metrics.
• Develop historical and projection-based analyses of claims and authorization data to support contracting proposals, including value-based arrangements.
• Ensure critical risk affiliations are accurately represented within organizational data, collaborating with leadership to identify and resolve discrepancies.
• Execute, deliver, and maintain established scheduled reporting processes.
• Collaborate with Care Management Associate leadership to review and analyze a variety of analytics outputs, including system, claims, and authorization data reports.
• Support the preparation and delivery of data for incorporation into existing reporting frameworks.
• Collect, organize, and store data provided by external departments and actuaries to enable downstream reporting.
• Ingest, format, and archive information received from external departments and actuaries for integration into downstream reporting systems.
• Develop, update, and maintain documentation for processes that impact key business workflows across departments, providing guidance to staff and identifying opportunities for improvement or enhanced knowledge.
• Prepare projection analyses of claims and utilization, including trend assessment and risk evaluation.
• Conduct claims analyses of required providers based on risk performance metrics.
• Develop historical and projection-based analyses of claims and authorization data to support contracting proposals, including value-based arrangements.
• Ensure critical risk affiliations are accurately represented within organizational data, collaborating with leadership to identify and resolve discrepancies.
• Participate in special projects and perform additional related duties as assigned.
  
  
  

Work Shifts

9:00 AM- 5:00 PM

Minimum Qualifications

• Bachelor’s Degree or a minimum of 2 years of experience industry related (business, health care, consulting, insurance, government)
• Insurance operations experience preferred.
• Proficiency in Microsoft Excel, Access and Word are necessary.
• SQL Query skill highly recommended.
• Experience with statistical systems and data reporting.
  
  
  

Professional Competencies

• Integrity and Trust
• Customer Focus
• Functional/Technical skills
• Written/Oral Communication
  
  
  

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