Manager - Performance Analysis & Reporting (TPA)

Role Purpose:Execute and complete specific deliverables and activities that analyze, validate, standardize the data-gathering process as well as report statistical data & performance metrics from multiple sources (e.g. insurance processing, performance metrics, clinical operations, demographics, costing reports .. etc) in order to fulfil our business and customers’ needs.Healthcare Data Analysis:Design data models that integrate patient data from multiple sources to create complete views of health data.Analyse members health risk segmentation and chronic cases profiling (e.g., chronic disease, cancer, hepatic disease, renal failure).Investigate data to find patterns and trends.Performance Analysis and Reporting:Pull and integrate data from multiple sources.Analyze data to assist in delivering optimal healthcare management and decision making.Publish monthly reports for mega accounts including different dimensions.Develop reports and presentations.Ensure accurate and timely completion of daily and monthly reports of all performance metrics.Communicate analytical insights with management.Data Cleansing:Apply advanced categorization of services with standardized and concise mapping.Ensure proper validation of doctor names in the data, specialties, modifying and validating of the unified service coding process.Analysis and reporting transformationinitiatives:Collaborate with the different business units and functions to execute the assigned objectives related to big data projects and digital enhancements, transformations and implementations.Interpret and validate data to be incorporated into advanced analytics and ML models.Automate the manual reports through power#J-18808-Ljbffr