PEHP - Health Data Analyst I

Description:
A division of Utah Retirement Systems, PEHP is a non-profit trust with the vital job of providing health benefits to Utah’s public employees and their families.
Job Description:

Summary:

Conducts cost and statistical analysis of business processes, medical and pharmacy claims data.  Updates, maintains and assists in populating underwriting models.  Prepares reports for dissemination and presentation.  Ensures integrity of reports and actively researches and corrects any inaccuracies discovered.



Duties and Responsibilities:

    Analyzes a wide variety of data and information.  Identifies utilization, cost, and risk trends. Recommends strategies to enhance decision-making, reduce costs, and increase organizational efficiency and effectiveness.
    Analyzes data from various database structures, such as claims (medical, pharmacy and dental).  Selects data and ensures the accuracy of the data in a timely manner.
    Utilizes SQL and other software to update claims, member counts, premium rates and risk scores in underwriting models.
    Prepares enrollment, premiums and claims reports for PEHP groups on a monthly basis. Ensure reports are accurate, complete and are distributed in a timely manner to the appropriate personnel.
    Updates models to analyze data and forecast the impact of formulary, benefit and contract changes.
    Coordinates efforts with Actuary and Underwriting staff through the data standards workgroup to ensure that best practices are being followed to extract and analyze the data.
    Presents data and conclusions to the Chief Actuary and senior staff.
    Creates reports tracking medical and pharmacy trends on a monthly basis stratified by diagnosis, drug therapeutic category, place of service, and medical service types.
    Investigates and takes action to correct any discrepancy in the data to ensure the integrity of the reports.
    Updates tools for departments to gather data and generate reports.
    May provide ad hoc analysis and support for other PEHP Departments.
    Participates on committees and taskforces as assigned.
    Maintains strict confidentiality.
    Performs other related duties as required.

Qualifications:
Education and Experience

Bachelors degree with experience in data analysis and one (1) year of data analysis experience.  Experience related to health care is preferred.



Knowledge of SQL, Tableauand the claims payment process is preferred.



Knowledge, Skills, and Abilities

Requires extensive knowledge of computer applications in Word and SQL;intermediate knowledge of Microsoft Excel specifically pivot tables and intermediate formulas; practical experience in statistical work; mathematical skills; applicable writing skills. Working knowledge of Tableau is preferred.



Must have a working knowledge of different data type structures that enhance data mining capabilities, and familiarity with data mining and database structure with particular emphasis on medical, pharmacy and dental claims is preferred.



Must have the ability to communicate effectively, verbally and in writing; ability to follow written and verbal instructions; prioritize work and perform within deadlines; manage multiple projects simultaneously; analyze problems and data; use sound judgment in decision making and problem solving.



Work Environment

Incumbent performs in a typical office setting with appropriate climate controls. Tasks require a variety of physical activities which do not generally involve muscular strain, but do require activities related to walking, standing, stooping, sitting, reaching, talking, hearing and seeing. Common eye, hand, finger dexterity required to perform essential functions. 

Apply:
https://careers-urs.icims.com/jobs/2141/health-data-analyst-i/job?mobile=false&width=610&height=500&bga=true&needsRedirect=false&jan1offset=-420&jun1offset=-360