EMC Analytic Specialist (medical claims)

Aurora, CO 80014

JOB SUMMARY: Supports Resource Stewardship department and the External Medical Cost (EMC) Unit goals and accountabilities by providing analytic expertise which promotes understanding of external medical costs, cost drivers and opportunities for cost structure improvement. Accountable for creating a culture of compliance, ethics and integrity. Maintains knowledge of and assures departmental compliance with Kaiser Permanente’s Principles of Responsibility and policies and procedures, and applicable regulatory requirements and accreditation standards. Responds appropriately to observed fraud or abuse.

POSITION REQUIREMENTS: Bachelor’s degree required in a field such as business, health care administration or computer services. Minimum of four to six years of experience performing business analytics and report development that includes the skills below:
Intermediate to advanced PC proficiency with Microsoft Excel, Microsoft Word, Microsoft Access and graphics.
Demonstrated experience in data extraction, spreadsheet analyses (e.g., pivot tables, statistical analysis) and database solutions using tools such as MS Excel or Access, Business Objects or SAS.
Proficient with complex data sets such as health care claims, research data or similar data sets.
Demonstrated experience developing action-based scorecards and other reporting processes using tools such as Business Objects, SAS or Crystal Reports.

Demonstrated customer service skills, customer focus abilities and the ability to understand Kaiser Permanente customer needs. Candidate must demonstrate knowledge of key influences impacting the business and implications.
This position may be filled at a higher grade, provided the candidate possesses appropriate qualifications.

ESSENTIAL RESPONSIBILITIES:
Builds queries using SQL in one or more tools (e.g. Business Objects, SAS, SQL Assistant, Crystal) to extract data from mainframe and server-based data repositories based on client requests.
Performs intermediate to advanced spreadsheet analyses using SAS, Excel or Business Objects; develops reporting processes and standard reports.
Utilizes critical thinking skills with regard to measurement and data; makes recommendations to management based on interpretation of data.
Coordinates data extraction, testing, and development of proposals for the annual operating forecast of professional, technical, other benefits and hospitalization expenses.
Capable of decision making that involves complex problem requiring extensive research, analysis and evaluation of multiple variables.
Grows expertise in KP data systems.


Functional and Environmental Factors available upon request.

Location:  2500 South Havana Aurora, CO 80014

SCHEDULE: MON - FRI - 8:00AM - 5:00PM

STARTING SALARY RANGE: $58,000 - $74,000 DOE plus excellent benefits package

- Kaiser Permanente is an AA/EEO employer -

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