Summary:

In this role, you will develop analytical models to identify payment anomalies in client’s healthcare claims data (fraud, waste or abuse). The results from your work will be reviewed by clinical analysts for outcome success. To be successful in the role, you will have sound knowledge and experience statistical models, data mining, machine learning, building analytical solutions to deliver insights, insights communication and presentation, as well as demonstrating the ability to combine advanced analytics skills with exceptional business acumen.

Responsibilities

• Develop a deep understanding of the key initiatives of the organization and be able to provide analytical solutions that provides actionable recommendations to drive the success of the key initiatives
• Lead the development of analytical models for new and ongoing product lines
• On-going monitoring of product lines including but not limited to the success metrics for each model and dashboards required for executive decision-making
• Serve as an additional point of contact and on-demand resource for analytic requests
• Capable of applying the latest technologies and methodologies in machine learning, data mining and predictive analytics to correlate disparate datasets and events and derive value
• Has a proven ability to learn quickly and works well both independently as well as in a team setting
• Communicate analytical findings and recommendations in a clear and concise way to non-technical audiences, both in oral and written presentations
• Work closely with information management teams to automate recurring tasks and improve processes to continually increase efficiency

Qualifications

• Bachelor’s degree in business, economics, statistics, mathematics, actuarial science, public health, health informatics, healthcare administration, finance or related field. Master’s degree preferred
• Experienced with languages used to manipulate data and draw insights from large data sets (e.g., Python, R, SQL, etc.)
• Working knowledge of analytical tools, including machine learning, statistics, SAS, Tableau, Hadoop, or related tools preferred
• 3+ years of experience in healthcare analytics, creating strategic plans and operationalizing functional teams in direct relation to meeting business needs or realizing goals tied to strategic objectives
• Understanding of healthcare claims adjudication and claims content preferred
• Demonstrate good understanding of healthcare data analytics terminology and concept, e.g., ICD, CPT, REV, DRG, etc.
• Experience in strategic planning and solutioning preferred. Broad exposure and understanding of statistical, analytical or data mining techniques and appropriate application of these capabilities in a business performance environment preferred
• Experience with report/dashboard development, data/report automation, self-service capabilities, data design and integration or data quality and governance preferred
• Must have demonstrated the ability to solve complex problems with minimal direction

Job Type: Contract

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Compensation package:

• Bonus opportunities

Experience level:

• 3 years

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Education:

• Bachelor’s (Required)

Experience:

• Machine learning: 3 years (Required)
• SQL: 3 years (Required)
• Healthcare claims: 3 years (Required)
• Python, R, or equivalent: 3 years (Required)

Work Location: Remote

Job Summary

In conjunction with the sales and operations teams, the Director, Account Management will be responsible for increasing customer engagement and managing new and existing client relationships to ensure optimal client satisfaction in balance with organizational priorities. The position’s primary objective is to coordinate, plan and deliver client results in periodic client business reviews and other ad hoc communications, track and complete all follow up items and identify new opportunities to grow and enhance existing client relationships. This position will report directly to the Chief Strategy Officer.

Qualifications

• Advanced Microsoft Office skills: creating presentations, Word reports & documents with advanced formatting, creating Excel spreadsheets
• Excellent written communication skills with the ability to compose professional business communications via email and proposals
• Excellent verbal communication and relationship-building skills with the ability to present professional demonstrations, foster trust, and communicate in a neutral, data- and fact-driven manner
• Ability to work in fast-paced, dynamic and ever-changing environment, adaptable
• Excellent organization skills and ability to track follow-up and deliverables
• Interpersonal skills with the ability to work well with all levels of the organization
• Quick study and takes initiative, with the ability to master a situation, identify needed skills and learn new things without explicit direction
• Ability to train support staff, act as a mentor and guide and develop team members
• Bachelor’s degree or the equivalent combination of education and work experience
• Minimum years of career experience to qualify for the role: 5
• Total years of career experience to be fully proficient: 10

Responsibilities

• In coordination with and at the direction of the executive/sales manager, nurture new client relationships and build upon existing client relationships as the key contact/relationship owner for assigned customers
• Keep apprised of sales efforts, participating in developed client prospect dialogues at the request of executives/sales for seamless process and relationship-building
• At executive’s/manager’s discretion, collaborate with new clients and their respective carrier(s)/PBM/other external constituents on all necessary documentation and other items in order to onboard new clients
• Own the existing client business review and client progress update process, from collaboration with relevant internal constituencies and deep knowledge of client needs, priorities and opportunities to develop agenda, to internal planning calls and coordination of tasks needed to deliver exceptional, thoughtful insights in every client interaction
• Collaborate with the data team and become fluent in Data Quality Review output and internal portal/analytics systems to be able to fluently access needed information for client dialogues
• Participate in, and ultimately (at the executive’s request) host, weekly internal implementation calls with relevant parties to ensure sales, data and operations teams are aligned on project deliverables, priorities, strategy and timing
• Develop and maintain strong executive relationships throughout the company
• Attend, participate in and lead certain external and internal meetings across the company, as requested or required in order to maintain a deep understanding of client and organizational priorities
• Track activity in CRM (Pipedrive) and/or other agreed tracking tools
• Take ownership of seamless communication to manager/executive on all client relationships, updates and/or potential challenges

Candidates selected for further consideration will be contacted.
Only qualified applicants should apply.

Job Type: Full-time

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Experience level:

• 5 years

Schedule:

• 8 hour shift
• Monday to Friday

Experience:

• Lead, Account Management: 5 years (Required)

Work Location: Hybrid remote in Plano, TX 75093