permanent data scientist in fort lauderdale

posted
contact
leslie pearl, tatum executive services
job type
permanent
salary
US$ 120,000 - US$ 140,000 per year
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job details

posted
location
fort lauderdale, florida
job category
Health & Social Care, Practitioner & Technician
job type
permanent
working hours
9 to 5
salary
US$ 120,000 - US$ 140,000 per year
experience
3 Years
reference number
496596
contact
leslie pearl, tatum executive services
phone
404.418.4665

job description

job summary:

Permanent Data Scientist position with a large healthcare client in South Florida.

Competitive salary and relocation. Remote candidates will be considered

Data Collection and Reporting

  • Collects Claims and Monthly Report data from payer partners including but not limited to Chronic Patients without PCP, Top 10 drugs, ED Frequent Flyer, High Claimants, Attributed members, care gaps, amongst others.
  • Utilizes software applications for data collection and analysis.
  • Responsible for the accurate and timely entry of data into the programs database.
  • Responsible for splitting and distributing individual sub-network data including claims files and reports in a monthly basis
  • Creates meaningful reports for use by clinical and support staff in order to manage attributed patients
  • Creates meaningful reports for use by the administrative team in order to keep accountability amongst the different networks
  • Assist with financial and quality reconciliation in a quarterly basis.
  • Responsible for updating network roster for internal and external stakeholders

Ad Hoc Reports and Business Intelligence

  • Assist individual network with ad hoc reports outside of the standard reports in order to advance an specific initiative
  • Collaborates with workgroups in different area of the organization and provides them with the necessary data point to advance strategic imperatives
  • Works closely with executive director to analyze future opportunities including strategic partnership, new service lines, and new contracts.
  • Use of public reportable data to analyze network integrity and opportunities for expansion

Risk Score and Documentation Audits

  • Performs monthly review of high cost claimants versus risk score allocation to determine any opportunities for the network and/or errors in the payers allocations
  • Performs audits in claims and clinical data at the individual network level to identify providers that require documentation education
  • Monitors new high cost claimant reports provide by the payer versus internal reports to assure that we are capturing all patients needing care management and additional resources
  • Educates network in the importance of documentation and adequate risk scores in a regular basis

Contract Analytics and Risk Readiness Support

  • Analyzes current and past share savings methodology for the different payer partners and make recommendations on future methodology that maximize network opportunities to receive incentives bases on quality and cost efficiency performance against the market trends
  • Monitors individual network trend under each contract to identify any outliers and/or potential risk
  • Collaborates with executive team and managed care departments to identify providers ready to advance to risk agreements
 
location: Fort Lauderdale, Florida
job type: Permanent
salary: $120,000 - 140,000 per year
work hours: 9 to 5
education: Bachelor's degree
experience: 3 Years
 
responsibilities:

Data Collection and Reporting (Weight: 30.00%)

  • Collects Claims and Monthly Report data from payer partners including but not limited to Chronic Patients without PCP, Top 10 drugs, ED Frequent Flyer, High Claimants, Attributed members, care gaps, amongst others.
  • Utilizes software applications for data collection and analysis.
  • Responsible for the accurate and timely entry of data into the programs database.
  • Responsible for splitting and distributing individual sub-network data including claims files and reports in a monthly basis
  • Creates meaningful reports for use by clinical and support staff in order to manage attributed patients
  • Creates meaningful reports for use by the administrative team in order to keep accountability amongst the different networks
  • Assist with financial and quality reconciliation in a quarterly basis.
  • Responsible for updating network roster for internal and external stakeholders

Ad Hoc Reports and Business Intelligence (Weight: 25.00%)

  • Assist individual network with ad hoc reports outside of the standard reports in order to advance an specific initiative
  • Collaborates with workgroups in different area of the organization and provides them with the necessary data point to advance strategic imperatives
  • Works closely with executive director to analyze future opportunities including strategic partnership, new service lines, and new contracts.
  • Use of public reportable data to analyze network integrity and opportunities for expansion

Risk Score and Documentation Audits (Weight: 30%)

  • Performs monthly review of high cost claimants versus risk score allocation to determine any opportunities for the network and/or errors in the payers allocations
  • Performs audits in claims and clinical data at the individual network level to identify providers that require documentation education
  • Monitors new high cost claimant reports provide by the payer versus internal reports to assure that we are capturing all patients needing care management and additional resources
  • Educates network in the importance of documentation and adequate risk scores in a regular basis

Contract Analytics and Risk Readiness Support (Weight: 10%)

  • Analyzes current and past share savings methodology for the different payer partners and make recommendations on future methodology that maximize network opportunities to receive incentives bases on quality and cost efficiency performance against the market trends
  • Monitors individual network trend under each contract to identify any outliers and/or potential risk
  • Collaborates with executive team and managed care departments to identify providers ready to advance to risk agreements
 
qualifications:

Bachelors Degree

3-5 years of coding

 
skills: Business Analysis

Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

skills

Business Analysis

qualification

Bachelors Degree

3-5 years of coding 

 

 

responsibilities

Data Collection and Reporting (Weight: 30.00%)

 

  • Collects Claims and Monthly Report data from payer partners including but not limited to Chronic Patients without PCP, Top 10 drugs, ED Frequent Flyer, High Claimants, Attributed members, care gaps, amongst others.
  •  Utilizes software applications for data collection and analysis.
  •  Responsible for the accurate and timely entry of data into the programs database.
  • Responsible for splitting and distributing individual sub-network data including claims files and reports in a monthly basis
  • Creates meaningful reports for use by clinical and support staff in order to manage attributed patients
  • Creates meaningful reports for use by the administrative team in order to keep accountability amongst the different networks
  • Assist with financial and quality reconciliation in a quarterly basis.
  • Responsible for updating network roster for internal and external stakeholders

 

Ad Hoc Reports and Business Intelligence (Weight: 25.00%)

 

  • Assist individual network with ad hoc reports outside of the standard reports in order to advance an specific initiative
  • Collaborates with workgroups in different area of the organization and provides them with the necessary data point to advance strategic imperatives
  • Works closely with executive director to analyze future opportunities including strategic partnership, new service lines, and new contracts.
  • Use of public reportable data to analyze network integrity and opportunities for expansion

 

Risk Score and Documentation Audits (Weight: 30%)

 

  • Performs monthly review of high cost claimants versus risk score allocation to determine any opportunities for the network and/or errors in the payers allocations
  • Performs audits in claims and clinical data at the individual network level to identify providers that require documentation education
  • Monitors new high cost claimant reports provide by the payer versus internal reports to assure that we are capturing all patients needing care management and additional resources
  • Educates network in the importance of documentation and adequate risk scores in a regular basis

 

Contract Analytics and Risk Readiness Support (Weight: 10%)

 

  • Analyzes current and past share savings methodology for the different payer partners and make recommendations on future methodology that maximize network opportunities to receive incentives bases on quality and cost efficiency performance against the market trends
  • Monitors individual network trend under each contract to identify any outliers and/or potential risk
  • Collaborates with executive team and managed care departments to identify providers ready to advance to risk agreements

educational requirements

Bachelor's degree