Job Description

- Managed Care (Full-Time, Day Shift) - Our mission is to participate in Jesus Christ's ministry, bringing health, healing, and wholeness to humanity by: Creating a supportive faculty practice framework that allows Loma Linda University School of Medicine physicians and surgeons to educate, conduct research, and deliver quality health care with optimum efficiency, deploying a motivated and competent workforce trained in customer service and whole person care principles and providing safe, seamless and satisfying health care encounters for patients while upholding the highest standards of fiscal integrity and clinical ethics. Our core values are compassion, integrity, humility, excellence, justice, teamwork and wholeness. The Performance Analyst supports Managed Care leadership by providing data management and analytics related to management of the Medicare Advantage and commercial populations and associated contract performance. Provides the foundation for data-driven recommendations and decision-making by executive leadership teams through the design and implementation of metrics aimed at operational and financial performance, with preparation of effective data display and dashboards. Includes tracking and update of RAF/Risk Adjustment scores, forecasting for both clinical and financial data impact, compliance with CMS and DMHC regulations as well as health plan contractual requirements for reporting. Performs other duties as assigned. Bachelor's Degree in business, health care analytics or related disciple required. Minimum four years of experience in managed care data analytics and/or management required. Four additional years of experience required in liue of degree. Understanding of managed care data analytics is required, including capitation and sub-capitation, utilization management, claims, case management, financial analysis, and HCC coding, and knowledge of CMS (federal) and DMHC (state) regulations. Ability to apply performance Improvement (PI) methodologies highly desirable. Proficiency required in data management skills, MS Excel, report and graphics development, and application of various analytics platforms. Able to keyboard 40 wpm. Able to use a computer, printer, and software programs necessary to the position (e.g., Word, Excel, Outlook, PowerPoint). Operate/troubleshoot basic office equipment required for the position. Able to work calmly and respond courteously when under pressure; collaborate and accept direction. Able to think critically; manage multiple assignments effectively; organize and prioritize workload; work well under pressure; problem solve; recall information with accuracy; pay close attention to detail; work independently with minimal supervision. Able to distinguish colors as necessary; hear sufficiently for general conversation in person and on the telephone, and identify and distinguish various sounds associated with the workplace; see adequately to read computer screens, and written documents necessary to the position. Our mission is to continue the teaching and healing ministry of Jesus Christ. Our core values are compassion, excellence, humility, integrity, justice, teamwork and wholeness. Loma Linda University Medical Center

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