Transformation Analyst III

Reporting to department leadership, the Transformation Analyst III leads cross-departmental efforts to utilize financial and/or clinical analytics to make strategic transformation recommendations and/or health/quality management recommendations, as well as implement quality improvement activities based on those analytics that revolutionize IEHP compliance standards, strategic goals, and initiatives. Key activities include engaging with stakeholders to develop and execute technical analyses, evaluating existing data sources, creating visualization tools, and recommending strategic business unit decisions and action plans. This position leads projects supporting key deliverables including study development, data collection, data analysis, policy interpretation, and policy creation and updates. The incumbent acts as the main liaison to support operations, quality improvement initiatives, and studies with leadership teams across the organization and, if applicable, hospital and ancillary providers. In addition to advanced analytical skills, the Transformation Analyst III displays expertise at integrating and preparing varied datasets, architecting analytical databases and visualization environments, and communicating results that are compliant with IEHP business rules and reporting requirements.

• Six (6) or more years of experience in study development, writing and analysis in healthcare (quality improvement, patient/provider services, healthcare finance, care management or related fields) required
• Demonstrated experience working with complex data systems and data sets
• Experience with electronic medical records, documentation, reporting/analysis required
• Master’s degree in mathematics, statistics, computer science, information systems, business administration, healthcare or related field from an accredited institution required
• In lieu of the required master’s degree, a bachelor’s degree in mathematics, statistics, computer science, information systems, business administration, healthcare or related field from an accredited institution and a minimum of two (2) years of hospital or health plan experience is required for this position
• This experience is in addition to the minimum years listed in the Experience Requirements above
• PMP, Lean Six Sigma, certified professional in Healthcare Quality, or other relevant certification preferred

Key Qualifications

• Valid California Driver’s License preferred
• Advanced knowledge and deep understanding of:
• Quality compliance standards, internal and external healthcare/hospital and business operations
• Available data sources and data systems, and appropriate data analysis criteria
• Statistical methods, data analysis, and study methodology
• Relational database structures and database design
• Department relationships and external partnerships to support daily operations
• Concepts, practices, and procedures within a healthcare setting preferred.
• Working knowledge of Medical terminology and knowledge of managed care, claims payment processes and insurance terminology required
• Advanced analytical skills with emphasis on healthcare services, finance, regulatory interpretations, and problem solving
• Ability to research, analyze data and make sound recommendations. Excellent verbal and written communication skills
• Advanced skills in utilizing Microsoft Suite applications
• Strong attention to detail. Ability to demonstrate a commitment to support IEHP’s efforts to become a 5-Star Health Plan and incorporate LEAN principles into daily work

Commitment to Quality: The IEHP Team is committed to incorporate IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation.

Perks

IEHP is not only committed to healing and inspiring the human spirit of our Members, but we also aim to match our team members with the same energy by providing prime benefits and more.

• Competitive salary
• State of the art fitness center on-site
• Medical Insurance with Dental and Vision
• Life, short-term, and long-term disability options
• Career advancement opportunities and professional development
• Wellness programs that promote a healthy work-life balance
• Flexible Spending Account - Health Care/Childcare
• CalPERS retirement
• 457(b) option with a contribution match
• Paid life insurance for employees
• Pet care insurance