Manager, Analytics

Job Summary

The Manager, Analytics is responsible for planning and managing the activities of a team of seasoned analysts that provide reports, insights, and analytics to L.A. Care’s enterprise reporting and analytics needs.

The Manager is responsible for developing the analytics solutions that meet the customer needs and deliver actionable insights to Enterprise Risk Adjustment and Encounters (ERAE) and Finance leadership, as well as to L.A. Care executive leaders.

This position is responsible for supporting Encounters and Risk Adjustment programs through the metric and key performance indicator (KPI) development, data modeling, investigative analytics, reporting, implementation, and coordination of initiatives and operational programs.  This position is the primary contact for encounter data and reporting to the Encounter Governance Committee (EGC).

The Manager is responsible for identifying, addressing, socializing and championing efforts to fix issue impacting encounter data cleanliness.  This position will develop and maintain relationships with key stakeholders across the enterprise to increase transparency to encounter data and the encounter process and access and appropriately use the most critical, actionable data to achieve their objectives.

This position manages all aspects of running an efficient team, including hiring, supervising, coaching, training, disciplining, and motivating direct reports.

Duties

Manage multiple tasks, adapt to change, and meet project deadlines in a dynamic environment

Design, produce, quality review, and support cross-functional teams in analytics to populate dashboards and KPI reports.  Manages and develops interventions to reconcile encounter submissions to minimize errors and data loss and perform root cause analysis.  Supports the performance of investigative analytics and root cause analysis in support of improving performance outcomes

Identify patterns and emerging trends based on aggregate data to find risks or opportunities and make performance change recommendations.

Work with key internal stakeholders to share important information and increase company awareness of relevant data.  Collaborates with key internal stakeholders to update, track, and report KPI for all Risk Adjustment programs and processes through reporting and dashboard development. 

Develops and maintains quality controls and validation reporting for relevant Risk Adjustment activities, submissions, and reports.  Prepares presentations, reports, process documentation, for internal and external stakeholders to support successful programmatic outcomes.

Acts as a resource for other members of the department on technical issues and identify ways to leverage technology, processes, and tools to solution for desired program outcomes.

Manages complex projects, engaging and updating key stakeholders, developing timelines, leads others to complete deliverables on time and ensures implementation upon approval.

Duties Continued

Plans and implements systems and procedures to maximize operating efficiency and achieve strategic priorities.

Develop goals, objectives and actions plans for assigned staff.

Lead the analytics and reconciliation team and ensure that all team members have the resources and support the need to meet objectives and succeed.

Perform other duties as assigned.

Education Required

Education Preferred

Experience

Required:

At least 6 or more years of experience in data analysis and information reporting.

At least 4 or more years of experience leading, supervising or managing staff.

3 or more years of interaction with Enterprise Data Warehouses (EDW).

3 or more years of individual contributor experience performing analysis on healthcare data (especially encounters).

Preferred:

Experience with Risk Adjustment methodologies.

Experience with claims, clinical, and/or financial data.

Experience with clinical documentation, medical records, and electronic medical record systems.

Analytics experience in management, actuarial/healthcare economics, risk adjustment and quality improvement programs. 

Analytics experience with Medicare Advantage, Medicare Fee-For-Service (FFS), Multipurpose Senior Services Program (MSSP) and Accountable Care Organization (ACO) programs, and commercial populations.

Skills

Required:

Understand and demonstrated ability to develop metrics used by regulators to monitor encounter and risk adjustment performance.

Understand and demonstrated ability to develop key performance indicators (KPI) and performance metrics

Proven ability to analyze and identify performance drivers as well as present key insights to management.

Proficiency in communicating analytic insights for stakeholder consumption in formats such as Tableau, Power BI, or other relevant tools.

Proficient skills on SQL, Python, R, SAS, SPSS

Experience in working with large, complex, disparate data sets

Experience with data interpretation, analysis, visualization, and reporting

Advanced level MS Excel for data analysis

Excellent verbal and written communication skills

Excellent presentation skills

Preferred:

Knowledge of managed care and health care claims

Knowledge of Risk Adjustment models (e.g. CMS Medicare Advantage, HHS-HCC, Medicaid DxCG)

Extensive knowledge of healthcare industry, Medicare Advantage, and Traditional Medicare

Licenses/Certifications Required

Licenses/Certifications Preferred

Required Training

Physical Requirements

Additional Information