As one of the nation’s leading pediatric health care systems, Nemours is committed to providing all children with their best chance to grow up healthy. We offer integrated, family-centered care to more than 300,000 children each year in our pediatric hospitals, specialty clinics and primary care practices in Delaware, Florida, Maryland, New Jersey and Pennsylvania. Nemours strives to ensure a healthier tomorrow for all children – even those who may never enter our doors – through our world-changing research, education and advocacy efforts. At Nemours, our Associates help us deliver on the promise we make to every family we have the privilege of serving: to treat their child as if they were our own.
Nemours is seeking a Business Information Analyst (Primary Care), FULL-TIME, to join our team in either Jacksonville, Florida or Orlando, Florida.
At Nemours, each Associate plays a vital role in supporting the delivery of world-class pediatric care to the children we serve. The team based at our home office in Jacksonville, Fla. provides essential administrative, financial and technical support to Nemours operations across all locations.
The Business Information Analyst is responsible for performance oversight, reporting and trending of medical costs, enrollment, utilization, clinical and quality measures for Children’s Health Alliance (CHA) Primary Care. Under the guidance of Primary Care leadership, this analyst may also participate in other population health analytics work, targeted improvement projects, data or analytics. Additionally, this role may also assist in the evaluation of financial risk and likelihood of meeting contractual performance targets under various proposed or existing alternative payment contracts. This role will also support ad hoc operations/clinical requests for data in support of CHA needs and will coordinate with other data and technology teams at Nemours.
This position can be located in either Jacksonville, Florida or Orlando, Florida.
Maintain and distribute up to date performance reports on value based agreements and population-wide quality measures identified by primary care leadership
Working closely with payers, conduct payer roster maintenance, updates and cleanup for assigned and attributed patient populations, provider lists and related payer data
Develop models for membership/payment reconciliation, provider attribution, and other models as necessary in order to accurately project and predict future contractual performance.
Develop and maintain data extraction, aggregation and validation models for disparate data from multiple sources (e.g., claims data) in support of quantitative analyses as well as operational, financial, and clinical reporting
Conduct cross-validation, data cleansing and quality checks for extracted data.
Support documentation of standard processes, data definitions, contract requirements, in an accessible manner
Develop and prepare scorecards, dashboards and summary reports showing high-level results and trends appropriate for different internal and external audiences.
Develop and execute analytical and/or investigative activities to provide stakeholders with information and tools for strategic decision-making and planning, health care utilization and costs, affordability opportunities, reimbursement projects and issues, population health and clinical outcomes, provider patterns and variations, trends and forecasting, data and informatics needs, and emerging technologies.
Participate in internal contract modeling focused on value-based agreements or alternative payment models (P4P, Shared Savings, etc)
Collaborate with IT and business units to advance Nemours reporting capabilities, tailor the design of population health technology solutions and improve accuracy of data.
Train stakeholders on how to interpret reports and data, as necessary, using the appropriate level for the intended audience
Bachelor's Degree required.
Minimum of three (3) to five (5) years experience required.
Experience managing performance analysis and reporting for an insurance plan or health system’s value-based initiatives.
PC, spreadsheet, and database skills.
Experience with SQL and data visualization.
Knowledge of healthcare terminology and strong knowledge of managed care data reporting and analysis such as HEDIS, quality of care studies, benchmarking, predictive modeling and risk stratification, etc.
Knowledge of value based care concepts and models including industry standard KPIs, analysis priorities, payer data formats, reconciliation techniques and more.
***EXTERNAL APPLICANTS: Please be advised if you apply to this position, you will be asked to take an assessment as part of the application process. This could add an additional 20 to 45 minutes, based upon the assessment that corresponds with this position. Please allow yourself enough time to complete the test, as you will not be able to save your application and come back to complete it at a later time. Do not use your mobile phone to apply to this position; our assessment is not compatible with mobile devices at this time **
Our dedication to professionals who are dedicated to children frequently earns Nemours a spot on the list of top workplaces in the communities we serve. Our Associates enjoy comprehensive benefits, including our unique “Bridge to a Healthy Future” pediatric health plan, an integrated wellness program, opportunities for professional growth, and much more. As an equal opportunity employer, Nemours focuses on the best-qualified applicants for our openings.
Nemours is committed to improving the health of children. As a non-profit children’s health organization, we consider the health of every child to be a sacred trust. Through family-centered care in our children’s hospitals and clinics in Delaware, New Jersey, Pennsylvania and Florida, as well as world-changing research, education and advocacy, Nemours fulfills the promise of a healthier tomorrow for all children — even those who may never enter our doors. Nemours began more than 70 years ago with the vision of Alfred I. duPont to improve the lives of children and to do whatever it takes to prevent and treat even the most disabling childhood conditions. Today, through our children’s hospitals and health system, we directly care for 250,000 children annually in Delaware Valley and Florida, including families who travel from across the country and world to see our specialists — treating every child as we would our own. We also reach beyond the walls of our hospitals and clinics to be a voice for children on a national and international level, and to lead the way in prevention, intervention, education, and research. Nemours is growing to better serve the children and families in our ca...re. We have 1.1 million square feet of space currently devoted to providing children’s healthcare or under construction, all designed with significant input and advice from our patients and families.