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Health Net, Inc. (NYSE: HNT) is among the nation’s largest publicly traded managed health care companies. Health Net’s mission is to help people be healthy, secure and comfortable. The company’s POS, HMO, insured PPO, behavioral health and government contracts subsidiaries provide health benefits to more than 7 million individuals. For more information on Health Net, Inc., please visit the company’s Web site at www.healthnet.com
JOB SUMMARY:
The Health Care Analyst collects and summarizes data for healthcare costs, utilization, quality and clinical outcomes in various medical management areas. Assists with gathering data, creating custom reports and programming and analyzing to address identified issues. Verifies accuracy of output and assists in developing standard informational formats.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
Extract and manipulate healthcare utilization data from various internal and external sources, tabulate data, and statistically analyze data using PC software and mainframe programs.
Forecast healthcare utilization trends.
Develop, analyze and present regular performance measurement briefings and books.
Make recommendations based on statistical analysis in both oral and written reports.
Identify data outputs for anomalies and trends and research and report on findings with recommendations for action.
Generate Utilization Management reports on a monthly, quarterly, annual and ad hoc basis and distribute to applicable recipients.
Assure that all reports, as required, meet HEDIS, NCQA, URAC and other regulatory reporting requirements.
Develop and support the development of online management information systems and report format and frequency standardization.
Establish and cultivate internal and external relationships and identify users of departmental output.
Work special management analysis projects as directed by management.
Perform other duties as assigned.
REQUIREMENTS:
Education:
Four-year college degree in Health Care, Finance, Accounting, Business or related field required.
Certification/License:
None required.
Experience:
Two to three years experience with manipulating and extracting data.
Knowledge, Skills & Abilities:
Working knowledge of SAS, Business Objects, Excel formulas and/or SQL.
OR
Any combination of academic education, professional training or work experience, which demonstrates the ability to perform the duties of the position.
As a government contractor, this position requires U. S. citizenship and proof of favorable adjudication following submission of Department of Defense form SF85P or higher security.
Health Net, Inc. supports a drug-free work environment and requires pre-employment background and drug screening.
Health Net and its subsidiaries are an Equal opportunity/Affirmative Action Employer M/F/V/D/
Location: Arlington, VA
Compensation: DOE
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