Lumeris Analytics Consultant in St. Louis, Missouri
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The Analytics Consultant is part of our analytics team and will play a key role in the development evaluation of provider based contracting, lifecycle of reports, dashboards, and other client deliverables. The role will require an understanding of company applications, business processes, and business needs for the Contract and Network Development team. You will gather and document business requirements, participate in technical design, and work with development teams to ensure successful deliverables. The candidate will participate in all phases of the development lifecycle from initial requirements gathering and design through coding and testing.
Roles and Responsibilities:
Understanding of current Hospital Medicare Inpatient DRG and Outpatient payment methodologies and Physician Medicare RBRVS pricing criteria
The Analyst will estimate claim payment and contractual allowance with payers by loading contract profiles in the contract management program to calculate the expected claim amount
Provide reporting of payment variance reviews
Review claims experience to find missed revenue opportunities
Operate in a self-directed work environment to accomplish goals and initiatives
Responsible for providing leadership in the planning of report distribution
Conduct internal and external customer interviews to gather business requirements and convert these to documents for consumption by development teams
Write requirements for analytics projects including and understanding of complex business rules, logic flow diagrams, conditional logic, use cases and user stories
Work to implement customer dashboards for critical success metrics reporting and tracking on programs and implementation
Analyze, manipulate and extract data from a variety of relational databases
Identify early trends that illustrate opportunities to implement corrective actions
Provide recommendations of specific actions or work based on analysis and research
Communicates actionable findings, provides recommendations to departmental leadership as well as other senior/executive management as appropriate
Work with industry standard data query and analysis tools to drive business decisions
Perform various ad-hoc analysis to drive business decisions across all functional business groups
Write and interpret complex SQL queries for standard as well as ad-hoc data mining
Other duties, as assigned
Experience, Qualifications and Education:
B.S. in Mathematics, Computer Science, related field, or relevant experience.
Master’s or equivalent in epidemiology, public health, mathematics, health services research preferred (but not required)
3+ years of experience in healthcare data analysis (including EMR/EHR, claims, eligibility and publicly available data such as CMS LDS) preferred
3+ years’ experience in Data Analytics, Contract Analysis, or related work
3+ years’ experience with SQL query writing within a Microsoft Technology environment with strong knowledge in SQL programming
Ability to query and extract data from a complex data warehouse using SQL and/or ETL tools.
Strong aptitude for analytical thinking and demonstrated data skills.
Demonstrated ability to work with large data and self-direct in analysis to reach recommendations and conclusions.
Proven leader that thrives in a fast paced environment
Able to manage relationships with internal and external business partners
Experience with Healthcare utilization metrics and reporting
Experience with assuring data quality and integrity
Excellent written and verbal communication skills
Flexibility and ability to handle multiple tasks and meet strict deadlines
Experience with Agile development methodology preferred
Experience with FACETs data preferred
Lumeris is an EEO/AA employer M/F/V/D.
St. Louis, MO
XL - FT
Join Our Growing Team!
Lumeris serves as a long-term operating partner for organizations that are committed to the transition from volume- to value-based care and delivering extraordinary clinical and financial outcomes. Lumeris enables clients to profitably achieve greater results through proven playbooks based on collaboration, transparent data and innovative engagement methodologies. Lumeris offers comprehensive services for managing all types of populations, including launching new Medicare Advantage Health Plans, Commercial and Government Health Plan Optimization, and Multi-Payer, Multi-Population Health Services Organizations (PHSOs). Currently, Lumeris is engaged with health systems, provider alliances and payers representing tens of millions of lives moving to value-based care.
Over the past seven years, we have tripled in size to more than 800 employees and built the only solution on the market with our proven outcomes. For the past six years, Essence Healthcare, a long-standing Lumeris client, has received 4.5 Stars or higher from the Centers for Medicare and Medicaid Services (CMS). Essence Healthcare was Lumeris’ pioneer client and has been leveraging Lumeris for more than a decade to operate its Medicare Advantage plans, which serve more than 60,000 Medicare beneficiaries in various counties throughout Missouri and southern Illinois.
In 2018, Lumeris was named Best in KLAS for Value-Based Care Managed Services in the area of client-reported impact on the Triple Aim by KLAS Research. This was the third year in a row Lumeris received the award, and it has only been given for three years. As the industry’s most reliable and effective partner for developing population health management solutions, our success is driving tremendous growth in our company. Join us today in making a real difference in how healthcare is delivered!
Why Join Lumeris?
At Lumeris, you will be part of team that is focused on solving the nation’s healthcare problem, and you will be able to contribute to our purpose. Our environment is fast-paced, change-oriented and focused on growth and employee engagement. At Lumeris, we know that talent is best utilized when given the opportunity to succeed. That is why we have removed the boundaries that inhibit success and focus on fostering an environment that allows employees to utilize their talents.