AmeriHealth Caritas Program Data Specialist Provider Network Management Clinical Community in Harrisburg, Pennsylvania

Program Data Specialist Provider Network Management Clinical Community


Description

Your career starts now. We’re looking for the next generation of health care leaders.

At AmeriHealth Caritas, we’re passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we’d like to hear from you.

Headquartered in Philadelphia, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at www.amerihealthcaritas.com.

Responsibilities:

The primary purpose of the job is to work closely with Plan functional area management/leaders to develop reports to monitor pertinent areas of functional areas of performance, such as, but not limited to Regulatory-driven programs and Value Based (VB) Contracting market share and programmatic impacts. Tracks and trends key indicators for Plan functional areas and utilizes data to support, monitor and provide direction as requested and required by assigned functional area. Collaborate with IS and Medical Informatics to create and establish data collection reports and monitor effectiveness of specific initiatives as appropriate in functional areas assigned. Examples include quality outcome driven programs health promotions programming like Patient Centered Medical Homes (PCMH); Suboxone Centers of Excellence (COE’s), Quality Enhancement Program (QEP) and corresponding VB initiatives and associated data, an ER program, wellness programs, medical management member support programs, outreach productivity and agreed upon terms with outside agencies. .Collaborates with a variety of corporate departments including Provider Network Management, statutory, Quality, Legal, Compliance and providers within the Plan network in providing a variety of data as needed. May develop ad-hoc reports for Plan Market President, Provider Network Management and Medical management.

Education/Experience:

  • Associate’s Degree.
  • Proficient in Excel and ACCESS, Word, Crystal Reports and Bi-Query. Proven ability to learn new applications used for reporting. Demonstrated ability to interface with all levels of management. Demonstrated meeting facilitation skills. Ability to analyze business area’s reporting needs and method of reporting to be used.
  • Proficient in examining and analyzing data from a reporting and data analysis perspective. Demonstrated use and knowledge of databases and integration of new systems.
  • Strong problem solving, analytical, organizational, and research skills
  • Demonstrated technical and project management skills with the ability to coordinate and manage multiple concurrent projects and delegate responsibility.
  • 1-3 years in a position with similar level of responsibility and complexity.

EOE Minorities/Females/Protected Veterans/Disabled