Health Care that Starts with You!

Join a truly mission-driven organization! Independent, nonprofit UCare is recognized as one of the Minnesota's leading health plans. We provide more than 225,000 members across Minnesota and western Wisconsin with the health coverage plans and services they need to maintain and improve their health. The innovative coverage we create makes a difference for Medicare-eligible individuals, individuals and families enrolled in Minnesota Health Care Programs, such as MinnesotaCare and Medical Assistance, and disabled adults with special health care needs.

UCare is growing in size, membership, products, geographic coverage, and employees. We're an organization that's going places. Be part of a team that cares about you, be part of UCare.

Rewards

Enter a highly collaborative environment where people are truly engaged, and feedback is valued. You'll enjoy a competitive salary and benefits, as well as a host of other perks, including a nationally recognized wellness program, and a bright, open, award-winning office space in Northeast Minneapolis just minutes from major freeways and retail centers.

At UCare, we welcome and employ a diverse employee group committed to meeting the needs of UCare, our members, and the communities we serve.

www.ucare.org/careers/

EOE/AA

ABOUT UCARE

At UCare, we deliver high-quality health coverage and services to help members of all ages maintain and improve their health. It's a big job that takes innovative ideas, strategic partnerships, and a commitment to doing the right thing. Above all, it takes a compassionate team that is dedicated to making a real difference in the lives of our members and our communities.

WORKING AT UCARE

Working at UCare is more than just a career; it's a mission. A mission that defines us as professionals, unites us as an organization, and shapes how we interact with our members and each other. Our values of integrity, community, quality, flexibility, and respect permeate every aspect of our organization - from who we are and how we act, to what we do and how we do it. We owe our continued success to our employees who proudly embody our mission and values in everything they do.

CLINICAL DATA ANALYST

Position Description

The position is responsible to perform analysis of utilization and other clinical data to support managing medical costs and determine areas of clinical focus. Perform analysis of health care data (i.e., medical and pharmacy claims, membership files and member interaction) to evaluate the quality and level of care delivered and measure the effectiveness of UCare's services on both clinical quality and identified cost drivers. This includes evaluation of utilization review, case management, disease management and clinical compliance activities. Assist in the definition, preparation, and analysis of reports for internal and external users.

• Perform analysis of utilization data to identify trends and patterns that impact the goals of Clinical Services and the organization; including but not limited to analysis of inpatient utilization, readmission data, and authorization data.

• Perform analysis of UCare medical management decision rules to enable management decisions regarding prior authorization, referral and notification requirements

• Conduct targeted studies of services or treatments that are identified as needing further investigation.

• Collaborate with UCare's Health Care Economics Department to extract relevant data required for report creation and effective analysis of key clinical quality and identified cost drives.

• Complete analytical reports for clinical and medical leadership that present in a well-organized and concise manner which is easily understood and clearly identifies areas of focus.

• Identify and gather data to benchmark UCare's medical management functions against industry standards and to compare against competitor's performance.

• Provide assistance by delivering information to support various projects that include, but are not limited to, quality improvement, cost containment, protocol-specific performance monitoring, clinical outcomes analysis, physician resource utilization, delegation oversight and compliance and market analysis.

• Demonstrate ability to integrate clinical, financial, cost, demographic, billing and other data from various sources when performing analysis and preparing reports.

• Collaborate with clinical and operational staff in the development of standard and ad hoc reports from clinical documentation system that meet operational needs.

• Partner with the Chief Nursing Officer, Clinical Services leadership, Medical Directors, and other Senior Leaders to perform evaluations of program effectiveness.

• Analyze data to determine effectiveness of logic in identifying "high risk" members for case management.

• Process and distribute routine operational reports. Support operational and clinical reporting needs with expertise on the clinical documentation system's attributes. Manage the portfolio of operational reports, collaborating with managers and users to evaluate current reporting.

• Serve as department subject matter expert while preparing work flows, queries and reporting for the clinical documentation system software.

• Review literature and provide recommendations as requested related to program operations.

• Serve as administrator for designated departmental software applications, including but not limited to assisting with the implementation, testing, trouble shooting, and routine upgrades.

• Develop expertise in the utilization of UCare's Business Intelligence tools, including Microsoft Office Suite, Microsoft SQL Management Studio, Mede/Analytics, Business Objects, Tableau, and other reporting software solutions for the purpose of compliance reporting for utilization review, disease management, case management/care coordination for routine and ad hoc reporting.

• Documentation and cataloging of routine data extraction/ report development processes. Categorizes and catalogs data sources.

• Other projects and duties as assigned.

Education

Bachelor's degree in health sciences research, mathematics or other field with a strong emphasis on critical thinking and program analysis. Statistic courses required. Master's degree or higher in business, accounting, finance or health care discipline preferred.

Required Experience

Experience with health care metrics with understanding of healthcare data and key concepts in the Managed Care and Disease Management industries. Statistical calculation and interpretation. Related database experience and experience with statistical and query software (Excel, MS Access, SQL, Tableau). Two years of health care industry, program analysis and software administrator experience.

Preferred Experience

Related database experience and experience with statistical and query software (MiniTab, StatPack, SPSS,).

THE UCARE DIFFERENCE

UCare is proud to be a recognized Star Tribune Top Workplace for the 10th consecutive year. As a part of our collaborative team, you'll experience the rewards that come with helping others and seeing the positive results of your hard work. We value and respect each individual's ideas and contributions, and give you the freedom to grow both personally and professionally. We are centrally located, and offer onsite education, equipment and wellness resources, a myriad of volunteer activities, and a number of other rewards. If you're looking for a welcoming environment that celebrates what you have to offer, helps you build on your strengths, and gives you the opportunity to truly make a difference, we invite you to apply.

As an Equal Opportunity/Affirmative Action Employer, we welcome and employ a diverse employee group committed to meeting the needs of UCare, our members, and the communities we serve.