Clipped from: https://www.learn4good.com/jobs/new-york-city/new-york/business/1971383977/e/
Position: Manager, Product Performance – Medicaid
The Product Performance Medicaid Manager will have experience in data analytics and Managed Care. Specifically, they will analyze complex business problems and issues using data from internal and external sources to provide insight to decision makers. They would identify and interpret trends and patterns in datasets to locate drivers and influences. Product Performance Medicaid Managers will construct forecasts, recommendations and strategic/tactical plans based on business data and market knowledge.
Must be able to collaborate with internal business areas to modify or tailor existing analysis to meet specific needs. They may participate in management reviews, including presenting and interpreting analysis results, summarizing conclusions, and recommending a course of action. The role will work with multiple types of business data, including claims, clinical, eligibility and financial. Job
Requirements Manage and mentor staff of analysts Collaborates with Finance, Analytics, Cost of Care and Clinical teams in support of the Director of Product Performance to ensure all products in Government Programs are performing at or above established financial and operational targets. The position leverages existing reporting and performs ad hoc analysis to provide visibility into emerging trends and areas of opportunity that need the attention of the business.
Working with leadership to define and stratify analysis requirements enabling leadership to meet strategic goals and tactical objectives. Lead and/or support margin improvement initiatives by working with internal business areas and vendors to ensure identified opportunities are implemented Collaborate and lead discussion with business area leadership to ensure issues and high priority projects have accountable owners and satisfactory progress to ensure financial, operational and compliance performance objectives are met Candidates must also have experience with identifying potential problems or opportunities to avoid issues and maximize opportunities by understanding what reporting/data is needed to monitor performance of Government Programs to identify and engage appropriate business owners.
Using knowledge of organizational informatics infrastructure, analytical tools, information systems, and other data stores to construct analytical models to support program evaluation, operational and clinical analyses, and reporting for responsible business units or organizations. Designing and implementing analytical solutions to improve processes, measure clinical quality goals, and meet regulatory reporting and analysis requirements. Manage dedicated production and support resources.
Qualifications:
Education Bachelor’s Degree or equivalent experience Master’s Degree preferred Experience 5+ years in a managed care organization Medicaid experience preferred MS SQL Server experience required
Virginia Premier, a division of Sentara Health Plan is currently seeking a Manager for Medicaid Product Performance. The Product Performance Medicaid Manager will have experience in data analytics and Managed Care. Specifically, they will analyze complex business problems and issues using data from internal and external sources to provide insight to decision makers. They would identify and interpret trends and patterns in datasets to locate drivers and influences.
Product Performance Medicaid Managers will construct forecasts, recommendations and strategic/tactical plans based on business data and market knowledge.
Must be able to collaborate with internal business areas to modify or tailor existing analysis to meet specific needs. They may participate in management reviews, including presenting and interpreting analysis results, summarizing conclusions, and recommending a course of action. The role will work with multiple types of business data, including claims, clinical, eligibility and financial.
Minimum Qualifications:
- Bachelor’s Degree or equivalent experience
- Master’s Degree preferred
- 5+ years in a managed care organization
- Medicaid experience preferred
- MS SQL Server experience required
Sentara Health Plan is the health insurance division of Sentara Healthcare doing business as Optima Health and Virginia Premier.
Sentara Health Plans provides health insurance coverage through a full suite of commercial products including consumer-driven, employee-owned and employer-sponsored plans, individual and family health plans, employee assistance plans, and plans serving Medicare and Medicaid enrollees.
With more than 30 years’ experience in the insurance business and 20 years’ experience serving Medicaid populations, we offer programs to support members with chronic illnesses, customized wellness programs, and integrated clinical and behavioral health services – all to help our members improve their health.
Benefits:
Sentara offers an attractive array of full-time benefits including Medical, Dental, Vision, Paid Time Off, Sick, Tuition Reimbursement, a 401k/403B with matching funds, 401a, Performance…