Role Overview
Responsible for the development, maintenance, and settlement of provider incentive models throughout the AmeriHealth Caritas Family of Companies.
• Ensures the maximum level of data accuracy, integrity, consistency, and completeness in the various internal and external data sources used for end-user reporting purposes (e.g., Oracle data warehouses).
• Identifies data-related issues and conducts root cause analyses; facilitates resolution of known issues by working directly with end-users and IT staff.
• Establishes business rules for the accurate use of reporting data fields. Identifies new and maintains existing sources of data to ensure the availability of information for reporting purposes.
• Generates and maintains thorough and accurate documentation related to data, databases, business rules, and reporting policies and procedures for all LOBs.
• Develops and executes test processes related to end-user data and databases; documents and tracks data-related issues and facilitates their resolution.
• Supports the identification of training opportunities related to data comprehension and reporting; assists with the creation of new models and metrics to track provider performance.
• The position interacts with associates at all levels in the organization, external clients, and vendors.
Work Arrangement
• Remote = Associate can work remotely anywhere in the United States
Education and Experience • Bachelor’s Degree in a relevant field required.
• Must have 3 to 5 years of proven Enterprise and Business analytics work experience in the managed care or Healthcare industry.
• Minimum of 5 years of Data Analysis, Reporting, and or Claims Processing required.
Skills & Abilities • Proven written communications aptitude with Value-Based collaterals (e.g. contracting, proposal development, program descriptions).
• Required experience developing Value-Based Programs and provider incentive models specific to: Episode of Care Model & Bundled Payment Model.
• Solid background with Statutory Reporting.
• Extensive knowledge of Microsoft Office products is required.
• Demonstrated proficiency with at least one reporting application such as SAS Enterprise Guide, SQL, and/or MS Access.
Your career starts now. We are looking for the next generation of health care leaders.
At AmeriHealth Caritas, we are 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 would like to hear you.
Headquartered in Newtown Square, 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.
Our Comprehensive Benefits Package
Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more.
