LogoFresh Jobs Ahead
PacificSource Health Plans
PacificSource Health Plans
1,001 – 5,000 Employees
HealthcareHealthcare InsuranceInsurance
PacificSource Health Plans is a healthcare insurance organization serving individuals, families, employers, and public-program members. Its coverage portfolio includes individual and family plans, employer-sponsored insurance, Medicare, Medicaid, dental coverage, and administrative services for group plans. The company also supports members through customer service, health-management resources, mental health support, and wellness programs.
LinkedIn
Company Jobs

VBP Data Analyst II

Analyze value-based payment data and support reporting at PacificSource Health Plans. The role covers data extraction, visualization, financial reconciliation, and reporting for employers, ASO groups, and regulators.

USUnited StatesNCNorth Carolina
$64,871 – $110,281 / year
RemoteFull-timeMiddleSeniorEnglish RequiredData Analyst
SQLTableau

Description

  • Coordinate data support for critical business analysis and reporting.
  • Extract, clean, transform, and prepare warehouse and nonstandard data using tools such as T-SQL and SAS.
  • Assist in building interactive visualizations with Tableau or Microsoft Power BI.
  • Create reports, analytical solutions, and processes for RFPs, large employers, ASO groups, and state and federal requests.
  • Calculate and analyze value-based payment terms, and assist with monthly reporting and financial reconciliation.
  • Explain complex data, analyses, and findings clearly to teams.
  • Create and maintain documentation, training materials, and job aids.
  • Assess how business changes affect risk report specifications.
  • Conduct ad hoc analyses of cost and utilization opportunities.
  • Assist with quality assurance, data validation, unit testing, error checks, and validation processes.
  • Build knowledge of health insurance and assigned analytics support areas.
  • Work with level 3 and 4 analysts, analytics management, and teams across departments.
  • Comply with privacy policies and HIPAA requirements for protecting confidential health information.
  • Meet department and company performance and attendance standards.
  • Carry out other assigned duties.

Requirements

  • At least three years of experience in health insurance or a related field.
  • Bachelor’s degree in mathematics, computer science, statistics, engineering, health and medical economics, public health, or a similar research-related field.
  • General familiarity with at least one statistical or analytical programming tool, such as R, SAS, or SPSS.
  • General familiarity with Tableau, Power BI, and web-based database tools.
  • Proficiency with Microsoft Word, Excel, PowerPoint, and Outlook.
  • Ability to manage multiple projects and competing deadlines.
  • Ability to manage workload within a team or with minimal direct supervision.
  • Ability to develop solutions to complex problems.
  • Ability to handle confidential information responsibly.
  • Ability to develop, document, and follow departmental policies and procedures.
  • Ability to read and understand written and spoken English.
  • Clear and effective communication skills.
  • Knowledge of business principles, theories, and concepts.
  • Preferred familiarity with Medicare Five-Star, Oregon Quality Incentive Measures, NCQA HEDIS, the Health Care Payment Learning & Action Network, the Alternative Payment Model framework, and the Facets claims processing system.
  • A master’s degree or higher is preferred.

Benefits

  • Equal opportunity employment.
  • Work-from-home arrangement.
  • Ergonomically configured equipment.
  • Travel required less than 5% of the time.

Related Jobs

Quest Analytics, LLC

Data Analyst, Healthcare Network Analytics

Quest Analytics, LLC
51 – 200 Employees
ConsultingHealthcareLogistics
USUnited StatesALAlabamaAZArizonaCOColoradoCTConnecticutFLFloridaIDIdahoILIllinoisIAIowaKSKansasKYKentuckyLALouisianaMEMaineMDMarylandMAMassachusettsMIMichiganMNMinnesotaMSMississippiMOMissouriMTMontanaNENebraskaNVNevadaNHNew HampshireNMNew MexicoNCNorth CarolinaNDNorth DakotaOHOhioOKOklahomaOROregonSCSouth CarolinaSDSouth DakotaTNTennesseeTXTexasUTUtahVTVermontVAVirginiaWVWest VirginiaWIWisconsinWYWyomingRemoteFull-timeMiddleSeniorEnglish RequiredData Analyst
JavaPythonScalaSparkSQL

Analyze healthcare data for Quest Analytics to improve provider network management. Develop metrics, data solutions, and AI-assisted insights to help optimize health plan networks.

Open