Job Information
Point32Health Lead Analyst MLR Optimization – Commercial in Canton, Massachusetts
Who We Are
Point32Health is a leading health and wellbeing organization, delivering an ever-better personalized health care experience to everyone in our communities. At Point32Health, we are building on the quality, nonprofit heritage of our founding organizations, Tufts Health Plan and Harvard Pilgrim Health Care, where we leverage our experience and expertise to help people find their version of healthier living through a broad range of health plans and tools that make navigating health and wellbeing easier.
We enjoy the important work we do every day in service to our members, partners, colleagues and communities. To learn more about who we are at Point32Health, click here (https://youtu.be/S5I_HgoecJQ) .
Job Summary
Under the guidance of the Director, MLR Optimization – Commercial, the Lead Analyst is responsible for oversight and in-depth analysis of the financial performance of the various segments within the Commercial line of business. This position will focus on monitoring unusual variances in performance, analyzing these variances, and packaging the analyses to communicate the results, thereby enabling pertinent areas to take appropriate action.
Key Responsibilities/Duties – what you will be doing
Understands the drivers of financial performance in healthcare
Understands linkages between financial and non-financial KPIs (e.g. HEDIS, Admits per 1000, attrition metrics)
Investigates unusual results and offers explanations
Develops criteria to validate results considering prior expectations
Packages results to demonstrate how the analysis meets plan / strategy objectives
Monitor monthly performance of the Commercial segments (MA, ME, NH, RI) to identify area of focus for revenue or cost optimization
Manage processes that control/monitor key drivers to achieve business goals
Oversees report development, queries, extracts, and generates insights to support financial and operational initiatives
Create / compile executive level presentations focused on business performance
Qualifications – what you need to perform the job
3-5 years of progressive experience in Finance, Actuarial or Medical Economics.
Bachelor’s degree in business. MBA strongly preferred
Robust understanding of Claims data, cost and utilization,
Experience in financial performance analytics and the generation of actionable insights
Strong working proficiency required in understanding and utilizing: Excel, Power Point and SQL
Strong analytic skills with the ability to synthesize and organize large data for meaningful use and action
organizational skills, to be able to package analysis together to frame the story
Well-developed presentation and communication skills
Energetic and proactive individual who strikes the right balance between self- initiation and collaborating with others
Demonstrated ability to master new content quickly
Must be able to manage and direct multiple priorities and meet deadlines in a fast-paced environment
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Commitment to Diversity, Equity, Inclusion, Accessibility (DEIA) and Health Equity
Point32Health is committed to making diversity, equity, inclusion, accessibility and health equity part of everything we do—from product design to the workforce driving that innovation. Our Diversity, Equity, Inclusion, Accessibility (DEIA) and Health Equity team's strategy is deeply connected to our core values and will evolve as the changing nature of work shifts. Programming, events, and an inclusion infrastructure play a role in how we spread cultural awareness, train people leaders on engaging with their teams and provide parameters on how to recruit and retain talented and dynamic talent. We welcome all applicants and qualified individuals, who will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.
At Point32Health, we strive to be a different kind of nonprofit health and well-being company, with a broad range of health plans, and innovative tools that make navigating health and well-being easier, guiding our members at every step of their health care journey to better health outcomes. We are committed to providing high-quality and affordable health care, improving the health and wellness of our members, and creating healthier communities across the country. The Point32Health name is inspired by the 32 points on a compass. It speaks to the critical role we play in guiding and empowering the people we serve to achieve healthier lives. Our employees are hard-working, innovative, and collaborative. They look for opportunities to grow and make a difference, and they help make us strive to be one of the Top Places to work in New England.