Job Description

Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 Members with the following programs:

* Medicaid State of Texas Access Reform (STAR) program for low-income children and pregnant women

* Children’s Health Insurance Program (CHIP) for the children of low-income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR

* Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre-existing conditions.

* Community Health Choice (HMO D-SNP), a Medicare Advantage Dual Special Needs plan for people with both Medicare and Medicaid that combines Medicare Part A and Part B benefits, Medicare Part D prescription drug coverage, and Medicaid benefits with additional health benefits like dental, vision, transportation, and more.

Improving Members' experiences is at the heart of every Community position. We strive every day to make sure that our Members have access to the high-quality health care they need and deserve.

Community is accredited by URAC for its health plan operations. We offer care management programs for asthma, diabetes, and high-risk pregnancy. An affiliate of the Harris Health System (Harris Health), Community is financially self-sufficient and receives no financial support from Harris Health or from Harris County taxpayers.

Skills / Requirements

Job Summary:

Provide leadership and direction for the development and implementation of Community Health Choice’s (Community) Analytics team overseeing the development of related staff, tools, data, and services for the entire health plan. As the Director of Analytics, you will take a customer service oriented, consultative approach to measure fast moving strategic priorities, surface opportunities, and drive operational excellence maturity. This position is responsible for data collection, aggregation, analysis, presentation, and self-enablement of decision support tools for Community leadership team and departments. The Director collaborates with all departments including Finance, IT, Operations, Growth, Compliance, Medical Affairs and Network Management from a strategic perspective to identify and maximize opportunities to utilize data to improve clinical outcomes, business processes, promote the strategic use of data, and enable the workforce, including self-help reporting and tools, to use data analysis and interpretation as a competitive tool.  

Responsibilities: 

Manages the Health and Human Services Commission (HHSC) and Texas Department of Insurance (TDI) and other governing bodies deliverables and ensures that reports are filed timely and accurately. 

Provides hands on technical expertise in querying and interpreting data, identifying trends, and delivering data-driven recommendations and insights in a clear and concise way to all levels, including C-Suite stakeholders, across all areas of the organization and that contributes to the analysis for strategic leadership priorities.

Collects and analyzes data to evaluate operational, financial and health services implications.Reviews data and reports and make conclusions, or outlines additional information needed.

Mentors and leads staff in producing well-written analytic summaries and visual summaries and visual data presentations appropriate for presentation to customers, management and/or senior leadership.  Participates in Data Governance activities to promote CHC towards a data-driven culture.

Establishes, maintains, evaluates, and modifies Key Performance Indicators (KPI) metrics to align with strategic goals of Community Health Choice. Works collaboratively with various departments to strategically identify opportunities to enhance usage of data along with business process improvement aimed at improving data quality to achieve company business goals.

Facilitates Analytics Department continuity through succession planning, team building, professional development and workflow/process documentation.
Actively contributes to achievement of departmental goals, as identified in Department’s annual business plan, including specific departmental process improvement plans, and other duties as assigned. 


MINIMUM QUALIFICATIONS:

Education/Specialized Training/Licensure:

  • Bachelors degree required in technical, mathematics, research, analytical field or other related field. Masters preferred

Work Experience (Years and Area):

  • 7 years of experience in business performance reporting, data analysis and proactive insights.
  • 3 yars of Managed Care and Medical claims experience preferred.

Management Experience (Years and Area):

  • 4 years of directly leading and managing teams

Software Operated:

  • Microsoft Office (Word, Excel, Access and Outlook);
  • Strong SQL Skills, SQL Server and Power BI;
  • Strong knowledge of Microsoft Azure, SSAS and data warehousing


SPECIAL REQUIREMENTS:

Communication Skills:
Above Average Verbal (Heavy Public Contact)
Exceptional Verbal (e.g., Public Speaking)
Writing /Composing: Correspondence / Reports

Other Skills: Analytical, Mathematics, Medical Terminology, Research, Statistical
MS Word, MS Excel, MS Access

Advanced Education:
Bachelors Degree: BA/BS required
Masters Degree Major: Strongly preferred in Healthcare Administration or related field.

Work Schedule: Flexible

Other Requirements:
- Knowledge of healthcare analytics
- Executive presence with excellent written and oral communication skills
- Aptitude in telling the story behind the data and translating analysis into insights and recommendations
- Ability to teach and mentor other employees, providing an opportunity for development and growth
- Excellent planning, and organizational skills
- Familiarity with medical coding, utilization trends and healthcare finance. 
- Strong analytical skills and business problem-solving skills.
- Expertise with SQL, SAS, PowerBI, Excel, Access or other report databases

RESPONSIBLE TO: COO

EMPLOYEE SUPERVISED: Professionals/Staff

Application Instructions

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