Data Analyst

Who We Are

Point32Health is a leading health and wellbeing organization, delivering an ever-better personalized health care experience to everyone in our communities. At Point32Health, we are building on the quality, nonprofit heritage of our founding organizations, Tufts Health Plan and Harvard Pilgrim Health Care, where we leverage our experience and expertise to help people find their version of healthier living through a broad range of health plans and tools that make navigating health and wellbeing easier.

We enjoy the important work we do every day in service to our members, partners, colleagues and communities. To learn more about who we are at Point32Health, click here.

Job Summary

Point32Health is currently seeking motivated individuals to join their Provider Reimbursement analytics team in the role of Data Analyst. A key role in the Corporate Data and Analytics organization, the Data Analyst will use analytic tools and processes to deliver meaningful insight on business performance. This role uses claims data and other supporting information to evaluate provider-specific reimbursements for rational and efficient methodology. Your expertise directly impacts financial stability, compliance, and operational capability.

Key Responsibilities/Duties – what you will be doing

Generate detailed analytics that focus on medical cost, reimbursement trends, and market position from a provider perspective across business lines and products (Commercial, Medicare, Medicaid, Exchange)

• Utilize extensive knowledge of managed care financing and in-depth understanding of reimbursement methodologies (DRG, PAF, fee schedule, pmpm, value-based payments) in order to develop meaningful assessment of financial performance
• Independently develop SAS and/or SQL queries, Excel pivot tables, and other analytic tools to explore and summarize results
• Produce regulatory submissions for the evaluation of provider cost trends
• Conduct other analyses as needed to support the identification of gaps, variation, and other key performance indicators of reimbursement trends
• Demonstrate problem solving aptitude through critique of analytic methodologies and studies
• Demonstrate strong business problem comprehension, by developing analytic use cases (Who? What? Why?) that accurately capture business needs
• Apply a high level of QA rigor, proactively leveraging peer review and external validation sources
• Develop documentation and methodologies for analyses and deliverables
• Meets assigned timelines and escalates risks/barriers as needed

• Establish strong business relationships, and interface with stakeholders collaboratively

Qualifications – what you need to perform the job

Qualifications

• Bachelor’s degree in an analytics-related field ( Healthcare Finance, Business, Economics, or similar); Masters degree preferred

• 3-5 years of experience, preferably in a payer/provider setting

Skills

• Moderate to complex analytics experience required, such as aggregation, normalization, and validation

• Intermediate programming skills (e.g., SAS, SQL) required

• Experience with health insurance claims data preferred

• Passion for data and problem-solving

• Aptitude for both “the forest” and “the trees”; able to simplify complex scenarios into key takeaways with compelling data storytelling, as well as drill down into the details behind the summary

• Proficiency with SAS and/or SQL programming, such as: creating new queries, extracting large data sets, and performing data manipulation and analysis.  A broad understanding of relational databases and large data structures is key

• Advanced Excel skills such as manipulation of large data sets; creating standardized reports; utilizing functions such as VLOOKUP, formulas, filters, and formatting; creating and interpreting pivot tables

• Demonstrated ability to manage tasks independently, take ownership of responsibilities and meet deadlines

• Strong written and oral communication skills

WORKING CONDITIONS AND ADDITIONAL REQUIREMENTS:

• Must be able to work under normal office conditions and work from home as required.

• May be required to attend meetings at other company locations or other external meetings.

• Work may require simultaneous use of a telephone/headset and PC/keyboard and sitting for extended durations.

• May be required to work additional hours beyond standard work schedule.

The above statements are intended to describe the general nature and level of work being performed by employees assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of employees assigned to this position. Management retains the discretion to add to or change the duties of the position at any time.

Compensation & Total Rewards Overview

As part of our comprehensive total rewards program, colleagues are also eligible for variable pay. Eligibility for any bonus, commission, benefits, or any other form of compensation and benefits remains in the Company's sole discretion and may be modified at the Company’s sole discretion, consistent with the law.

Point32Health offers their Colleagues a competitive and comprehensive total rewards package which currently includes:

• Medical, dental and vision coverage

• Retirement plans

• Paid time off

• Employer-paid life and disability insurance with additional buy-up coverage options

• Tuition program

• Well-being benefits

• Full suite of benefits to support career development, individual & family health, and financial health

For more details on our total rewards programs, visit https://www.point32health.org/careers/benefits/

Commitment to Diversity, Equity, Inclusion, Accessibility (DEIA) and Health Equity

​Point32Health is committed to making diversity, equity, inclusion, accessibility and health equity part of everything we do—from product design to the workforce driving that innovation. Our Diversity, Equity, Inclusion, Accessibility (DEIA) and Health Equity team's strategy is deeply connected to our core values and will evolve as the changing nature of work shifts. Programming, events, and an inclusion infrastructure play a role in how we spread cultural awareness, train people leaders on engaging with their teams and provide parameters on how to recruit and retain talented and dynamic talent.  We welcome all applicants and qualified individuals, who will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.

Scam Alert: Point32Health has recently become aware of job posting scams where unauthorized individuals posing as Point32Health recruiters have placed job advertisements and reached out to potential candidates. These advertisements or individuals may ask the applicant to make a payment. Point32Health would never ask an applicant to make a payment related to a job application or job offer, or to pay for workplace equipment. If you have any concerns about the legitimacy of a job posting or recruiting contact, you may contact TA_operations@point32health.org