Payer Data Analyst II

Information Technology Chicago, Illinois


Description

Company: Oak Street Health 

Title: Payer Data Analyst II 

Location: Treehouse (officially); remote (functionally)

Company Description

Oak Street Health believes everyone deserves great healthcare – the kind you’d want for your own family. We specialize in providing exceptional care for older adults on Medicare, often in underserved communities where there is little or no quality healthcare.

Oak Street Health is on a mission to rebuild healthcare as it should be with an innovative care model that centers on wellness-based, positive health outcomes for patients, not the volume of services provided. Our unwavering commitment to keeping patients healthy is highlighted by dedicated care teams that take time to get to know each individual, providing the personalized care they need to stay healthy and live life more fully. 

We’re an organization on the move! Our rapidly growing national network of primary care centers is staffed by a diverse team of outstanding care providers, service team members, technologists, community outreach experts, business professionals, and more. For more information, visit http://www.oakstreethealth.com.

 

Role Description:

As Oak Street Health continues to grow, there is an increased need to more efficiently process new payers’ incoming data as well as manage issue resolution arising from legacy relationships. Under the supervision of team management, the analysts scrutinize all incoming files coming from 25 payers and growing. Files range across eight subject domains: membership/eligibility, authorizations and referrals, medical claims, pharmacy  claims, the MMR, the MOR, the MAO-004, and quality gaps (HEDIS/STARS) files. The level of domain experience present will determine what level of analyst role a potential candidate will be hired into. The higher the role level equates both to more experience and mastery of multiple domain sets. As such, there are career paths available for those seeking to learn how an innovative provider group mobilizes health plan data for patient care delivery as well as roles for those to leverage their in-depth payer data knowledge in a new arena.  

Core Responsibilities:

  • Identify, analyze, and interpret trends or patterns in complex datasets commonly produced by health plans; expectations for incoming domain knowledge at time of hire:

    • Analyst II - Knowledge of health plan membership/eligibility data and one other domain, 1-2 years of prior experience

  • For new health plans, participate in negotiations for data at the start of new contractual relationships by assisting the Director of BI Governance and the Payer Data Ingestion lead/manager

    • Communication skills to speak at multiple levels to mixed payer audiences, including network managers, business SMEs and IT staff outside of Oak Street

    • Generate source-to-target mappings for the data warehouse during negotiations to aid internal Oak Street discussions centered around accepting new data

    • Perform data validation against benchmarks, statements of account and/or other sources provided by health plans

    • In the sandbox area of the data warehouse, create ad hoc warehouse tables and structures to validate received data (as needed)

  • For legacy health plans, contribute to resolution of data issues as they arise 

  • Aid Oak Street’s overall data quality and governance in conjunction with standards developed by Oak Street IT

  • Partner with operational analytic teams to execute data cleansing strategies to aid the use of payer data to support Oak Street’s mission

  • Other duties as assigned

What are we looking for?

  • Bachelor’s Degree and 1-5 years of experience in a healthcare role; both years of experience and demonstrated skill sets will help determine which level of analyst a candidate should be hired into

    • Preference will be given to candidates with healthcare data experience, whether in IT or as an embedded technology SME in operations

    • Previous experience working with large healthcare claims and/or EHR databases and their content favored

    • Applicants with an appropriate combination of education and experience will also be considered

  • Programming/development experience with MS SQL Server 2014 or newer

  • Programming experience with Python and pandas packages

  • Advanced experience with Microsoft Excel or other spreadsheet software

  • Healthcare informatics, analytics, and reporting knowledge

  • Data warehousing and/or IT project experience

  • Experience working with large data sets; common extracts will often include millions of data lines

  • Someone willing to make 2-4 trips annually to the Treehouse (Oak Street’s corporate headquarters) for face-to-face meetings

  • Working knowledge of healthcare concepts and their relationships with corresponding data (operations, membership, and finance)

  • Familiarity with healthcare data and data analytic platforms

  • Ability to prioritize and manage concurrent projects

  • Strong organizational skills

  • Execute work with exceptional attention to detail on all project tasks

  • Ability to work independently and within a diverse team environment

  • Strong verbal and written communication skills

  • Ability to prioritize tasks with little supervision and work under time pressure

  • Ability to be a team player in a matrix environment

  • Client consulting experience, especially end-user education of analysts and decision makers at all levels of the organization

  • US work authorization

  • Someone who embodies being “Oaky”

What does being “Oaky” look like?

  • Radiating positive energy

  • Assuming good intentions

  • Creating an unmatched patient experience

  • Driving clinical excellence

  • Taking ownership and delivering results

  • Relentlessly determined

Why Oak Street?


Oak Street Health offers our coworkers the opportunity to be at the forefront of a revolution in healthcare, as well as:

  • Collaborative and energetic culture

  • Fast-paced and innovative environment

  • Competitive benefits including paid vacation and sick time, generous 401K match with immediate vesting, and health benefits

Oak Street Health is an equal opportunity employer. We embrace diversity and encourage all interested readers to apply to oakstreethealth.com/careers.