Senior Business Intelligence Developer

Position Purpose:

Join a tenured team of IT professionals at Health Choice Management Company!

Our Business Intelligence team works closely with senior leadership – providing them with excellent data and the tools to make decisions that impact the future of Health Choice. We are a team of innovators, creative minds, problem solvers, and people who get things done! In the Business Intelligence team we've charged ourselves with one mission: to design and build first class reporting and analytical tools the support Medical, Financial, and Operational teams so that we can improve the health and well-being of our members.

The Senior Healthcare Report Developer role includes collecting, analyzing and reporting on health care data using SQL in combination with Excel, Qlik Sense, or SSRS. Reporting areas include medical and pharmacy claims, capitation, member, care management, quality and risk, clinical/medical, and provider information. This position develops and finalizes reporting required to proactively support medical management activities, provider contracting and management activities, financial and accounting activities, and other senior leaders of the company. The Senior Healthcare Report Developer provides key information critical to decision making, leveraging advanced SQL development to deliver value to key stakeholders. This position also mentors less experienced Healthcare Report Developers, takes on more complex projects, and is expected to take a leadership role in the peer review process both as peer reviewer and developer.

Responsibilities:

• Lead requirement analysis, validation and verification, ensuring that requirement statements are complete, consistent, concise, comprehensible, traceable, feasible, unambiguous, and verifiably actionable.
• Manages requirements traceability information and track requirements status throughout the project.
• Participates or leads in the peer review process to ensure all reports are reviewed before distribution
• Designs and develops reports and analyzes data to measure financial or clinical outcomes, network performance, care management, claims processing, operations and/or other areas of the business
• Develops medical cost reporting, including standardization of cost categories of service, unit cost and utilization metrics
• Assists in development of business requirements for decision support tools and reports
• Creates dashboards generated from trend data, utilization authorization, risk adjustment, and claims data to support departmental functions
• Models hospital, physician and ancillary contracts in order to advise network contractors during rate negotiations, as well as provide monthly analysis of overall network performance.
• Receive, interpret and complete data requests from Finance and other departments as necessary