Senior Healthcare Analyst/Data Scientist
Location: Milwaukee, Wisconsin US
Job Number: 900
This position is responsible for collaborating with clients, operational leads and subject matter experts to develop and implement tactics and strategy for optimizing profitability, clinical performance, member and provider satisfaction and client satisfaction by developing and leveraging analytic tools, financial models and reports, marketing and outreach. In addition to being an expert SAS, Tableau and Excel developer, each Lead Healthcare Analyst is responsible for maintaining close collaborative relationships with one or more DentaQuest Regional Vice Presidents and all client and provider directors and managers within the states in the assigned region, and for presenting recommendations, strategies and findings. The Lead Healthcare Analyst will organize, lead and support efforts to measure, analyze and report on trends enterprise-wide related to provider utilization, reimbursements, access to care, cost management, etc. and identify and promote strategies to positively influence access to quality, cost effective care and improved program performance. This individual will also work with other areas of the company, including Underwriting, Provider Services, Clinical Management and Client Services to assist in the understanding of provider cost and network trends impacting program costs and profitability and to recommend strategies for improvement wherever possible.
PRIMARY JOB RESPONSIBILITIES:
o Outcomes measurement
o Provider optimization
o Benefit structures and algorithms
o System edits, fraud detection, UM and UR
o Member behavior management
At DentaQuest, we believe that everyone should live life free of dental disease. As a purpose-driven, double bottom line company that is improving oral health for everyone, we are transforming the oral health system - from the way we provide care and pay for it, to how we talk about it and prioritize it in our policies and communities.
Meaningful change requires a revolution in oral health. We are redefining what it means to prevent disease and provide better access to care for everyone. We are going beyond the dental chair to reshape the oral health system, addressing total health and the social and cultural factors that impact it.
To make this revolution a reality, we harness our unique reach and insights to advance policy, financing, care, and the community. That means solving problems in a flexible and efficient way, testing and trialing to create new solutions and deliveringmeasurableoutcomes for the people we serve.
The people of DentaQuest have a common purpose, and we work together with passion, perseverance and focus to achieve a nation where no child suffers from the pain of tooth decay. Where adults keep all their teeth for their entire lives. Where every person has access to quality dental care.
Job Number: 2924
Community / Marketing Title: Senior Healthcare Analyst/Data Scientist
Location_formattedLocationLong: Milwaukee, Wisconsin US