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AM – Claims Performance Analyst
2 weeks ago
Main Purpose of Job:
AM– Claims Performance Analyst is responsible for leading data-driven initiatives to optimize claims performance and operational efficiency. This role oversees comprehensive analysis of claims data, develops advanced reporting and predictive models, and drives automation and process improvements. The position collaborates with cross-functional teams and senior leadership to deliver actionable insights and implement strategic solutions that enhance business outcomes.
Job Description:
- Lead comprehensive analysis of claims data to identify trends, root causes, and improvement opportunities.
- Utilize statistical methods and data visualization tools to present insights and recommendations to senior management for decision-making.
- Develop and implement performance dashboards for leadership visibility.
- Own development of advanced data models and automation tools to enhance claims performance tracking.
- Design and validate predictive models for trend forecasting and risk mitigation.
- Champion data-driven decision-making across cross-functional teams.
- Manage customization and automation of reporting systems to reduce manual effort.
- Assist in the creation of reports related to user daily, weekly, and monthly operational requirements.
- Ensure efficient and accurate generation of reports to support operational needs.
- Collaborate with stakeholders to understand reporting requirements and provide strategic guidance on report design and implementation.
- Monitor report performance and work with supervisors and Claim Data Analysts to identify opportunities for improvement and implement solutions.
- Work closely with internal teams to optimize data collection and analysis processes.
- Facilitate communication between stakeholders to ensure alignment on objectives.
- Assist in departmental projects focused on data analysis initiatives.
- Support specific projects that require data analysis expertise.
Qualification
- 3-5 years of experience in data analysis, data science, strategic reporting.
- 1-2 year of Healthcare, Insurance claims management, and experience in project management or another relatable industry would be advantageous.
Strong analytical and problem-solving skills.
Results-driven approach.
- Strong analytical, problem-solving, and communication skills.
- Exceptional commercial acumen and negotiation skills.
- Proven ability to manage teams and foster collaboration.