Plan Analytics Analyst Sr

1 month ago

Newtown Square, Pennsylvania, United States AmeriHealth Caritas Full time

Your career starts now. We are looking for the next generation of health care leaders.

At AmeriHealth Caritas, we are passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we would like to connect with you.

Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.

Discover more about us at

Under the leadership of the Manager Advanced Analytics, this position will lead with minimal supervision, share insights in a way that is easy to grasp and actionable, build relationships to help drive adoption of data- and insights-driven decision making across a variety of subject matters including, but not limited to Medicare, medical and quality management, authorizations, claims, SIU, statutory/regulatory, non-HEDIS, Jiva/eLTSS and population health. Be a key stakeholder at the table of leadership and support strategic vision and goals. The candidate will become their go-to source for data, reporting, insights, and guidance. They will guide decisions that impact the company's future - based on carefully thought-out, well-executed, complex analyses and actionable insights. In addition, they will be a mentor/coach to the other analysts in their day to day essential functions. This position will partner with plan manager and support them in daily decisions that are best for the team's performance.

Responsibilities:

  • Define business problems, assess relevant variables and forces that impact the issue, recognize relevant patterns in data, and provide solutions and information to solve business problems and needs; including BI dashboard development.
  • Drive management, operations units, stakeholders and the reporting staff to prepare clear, sound, accurate and informative reports containing findings, analysis, conclusions, and recommendations.
  • Generates data analytics to identify recovery opportunities for fraud, waste and abuse.
  • Be an expert with data mining across multiple data platforms (Facets, Jiva, eLTSS, CareAnalyzer, supplemental files).
  • Conduct and document QA testing for analytic and reporting solutions.
  • Cross-pollinate across multiple corporate areas to understand workflows, document processes and ensure highest quality product delivery.
  • Work on a fast paced team, with minimal direction focusing on understanding the application/product/area in detail, while delivering high-quality outputs and actionable solutions.
  • Serve as thought leader for technical business processes, developing forward-thinking prototypes that promote increased efficiency and productivity on multiple levels.
  • Learn rapidly and enthusiastically, focusing on understanding the application/product/area in detail
  • Coordinate and facilitate meetings on specific projects work with the business, analytic and development teams in the creation of visualizations and reports for requested projects.
  • Perform other duties as assigned by Management.

Education/ Experience:

  • Bachelor's Degree in Business, Computer Science, Healthcare Analytics, or equivalent hands-on experience of 7 to 10 years, with a preference in healthcare.
  • 3 years SQL/SAS programming experience.
  • 5 years of analytics experience.
  • 2 years Databricks/Pyspark
  • Superior organizational, close attention to detail and written/oral communication skills.
  • Superior technical writing skills in business requirements, queries, reports, and presentations.
  • Superior technical skills in Excel, PowerPoint, Tableau, Power BI, SQL, and SAS with the ability to learn other analytic and big data mining tools.
  • Advanced analytical and quantitative skills with experience collecting, organizing, mining, analyzing, visualizing and disseminating abundant information with the utmost accuracy and presentation.
  • Experience in conducting and documenting QA testing using problem-solving techniques for analytic and reporting solutions.
  • Efficiently manages time based on the continual evaluation of priorities, meets deadlines with high-quality deliverables reflecting a complete understanding of expectations, and is able to multitask.

Diversity, Equity, and Inclusion

At AmeriHealth Caritas, everyone can feel valued, supported, and comfortable to be themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace. Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.

We keep our associates happy so they can focus on keeping our members healthy.

Our Comprehensive Benefits Package

Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more.

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