Remote Insurance Verification Jobs in Findlay, OH

• Remote States: Ohio, North Carolina, South Carolina, Georgia, Tennessee and Florida

PURPOSE OF THIS POSITION

The Data Analyst works with the Directors/Managers throughout BVHS to research and analyze relevant clinical, utilization, cost, and program outcome data to identify opportunities to improve with the goal of controlling cost and utilization while maximizing health care outcomes. The associate will also create tools to allow staff to efficiently perform their activities, and oversee quality improvement efforts.

JOB DUTIES/RESPONSIBILITIES

Duty 1: Analyze and Report:

• Provide complete, thoughtful, and compelling evaluative information through peer collaboration and independent research, compilation, and analysis of data.
• Evaluate health care administrative data in order to identify cost, quality, and utilization trends.
• Coordinate collection, interpretation and analyses of healthcare data to improve quality, decrease costs, identify variability in healthcare costs and outcomes and inform cost containment programs ad interventions.
• Utilize statistical techniques to analyze and interpret trends or patterns in complex data sets.
• Provide reports and recommendations to management that result in effective relationships with providers, convenient access to high-quality and cost-effective care for members.
• Provide reports and recommendations to staff to facilitate quality improvement, care management, population health initiatives, program development, process improvement, and staff efficiency.

Duty 2:  Research and Development:

• Work independently and collaboratively with stakeholders in the Division to develop and maintain decision-support tools. 
• Ensure analytical reports and outputs are consistent with the enterprise; verify the accuracy, integrity, and relevance of the required data. 
• Elicit business and functional requirements by identifying and organizing desired outcomes and key performance indicators. 
• Provide database observations and recommendations to improve departmental operations and cultivate continuous process improvement.
• Develop reports and data analyses, which support quality and annual business plans.
• Share expertise with and train other staff on data issues, interpretation, and reporting tools.
• Assist with designing and executing standard and ad hoc reports
• Utilize relevant benchmarking databases to analyze operational and strategic opportunities. 
• Assist in the evaluation of products, programs and/or clinical initiatives.
• Recommend modifications and corrective actions to existing practices as appropriate.
• Work with other members of the technical team to assist in improving processes and procedures related to the design and delivery of requests for customers.

Duty 3:  Information Services Involvement:

• Support reporting applications including regular maintenance, evaluation of reported issues, testing and upgrading.
• Perform job duties in accordance with IS policies.
• Work collaboratively with other team members on interdepartmental and intradepartmental projects.
• Participate in meetings related to duties assigned to you.
• Project Management/IT Project Lead for small and large projects requiring data extractions/reports from the technical team, including creating project documentation, managing resources and deadlines and overcoming barriers for projects.

REQUIRED QUALIFICATIONS

• Degree in nursing, health care, informatics, or information systems or related field or commensurate experience.
• Minimum of five years of experience working in health insurance or health care.
• Minimum of two years of experience in data extraction from multiple data sources and reporting.
• Knowledge of relational database design, analytic and reporting methods, tools, and procedures.
• Knowledge of Internet for research and word processing, spreadsheet, presentation, and database applications (Microsoft Word, Excel, PowerPoint, Access).
• Verbal and written communication skills, including the ability to negotiate and compose clear, concise correspondence, internal policies and procedures, and narrative reports.
• Excellent analytical skills, including the ability to identify problems, research and analyze issues from different perspectives.
• Ability to use reporting software and tools to produce accurate and meaningful reports, and perform business analysis or process improvement.
• Ability to work independently and to establish, monitors, and achieve goals with minimal supervision.
• Ability to work as an effective team member with staff at all levels.
• Ability to engage and interface with a broad and diverse set of internal and external stakeholders, such as business owners of data, operational or system data stewards, various analytical and reporting end-users, and Information Systems representatives across the range of data architects, developers, and system analysts.
• Ability to be composed and adaptive in a dynamic, fast-paced, customer-focused work environment characterized by rapid change, minimal lead times, and multiple competing priorities.
• Results driven.
• Personable and ability to work well with others.
• Accountable, open, candid and transparent.
• Flexibility to work the number and schedule of hours needed to accomplish regular and ad hoc job responsibilities.
• Commitment to excellence in customer service and the BVHS cultural and other values.
• Commitment to achieving the BVHS key results.
• A valid driver's license is required (if you do not have a valid Ohio driver's license you must obtain one within 30 days of your residency in the state).  You must also meet BVHS's company fleet policy and insurance company requirements, and any other requirements that may be required to operate a vehicle.
• Positive service-oriented interpersonal and communication skills required.

PREFERRED QUALIFICATIONS

• Knowledge of Business Objects and SQL.
• Knowledge of provider reimbursement methodologies, including evolving innovations in reimbursement models and emerging industry trends.

PHYSICAL DEMANDS

Performing physical activities that require considerable use of your arms and legs and moving your whole body, such as climbing, lifting, balancing, walking, stooping, and handling of materials.