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ClaimsXten Senior Claims Data Analyst
Job ID R28022
Date posted 12/07/2022
TPG Capital recently completed the purchase of Change Healthcare’s Clinical Claims Management (CCM) business, which includes the ClaimsXten®, ClaimsXten® Select, ClaimCheck, Secondary Editing, and Episode Manager solutions. The transaction establishes the CCM business as an independent company, with an interim name of ClaimsXten Portfolio. ClaimsXten Portfolio has a long history as a trusted partner and market leader in primary claim editing, delivering value through savings, operational efficiencies, and long-standing partner relationships.
TPG Capital is a leading private equity platform of alternative asset management firm TPG and an active, experienced healthcare and software investor. TPG has a long history of partnering with companies, including the ClaimsXten Portfolio Business–a trusted partner and market leader in primary claim editing, delivering value through savings, operational efficiencies, and long-standing partner relationships. ClaimsXten’s primary solutions are ClaimsXten®, ClaimsXten® Select, ClaimCheck, Secondary Editing, and Episode Manager.
- Fully Remote - U.S.
The Senior Data Analyst performs analysis of large claims data sets in support of the clinical claims editing business. Common tasks include the modeling or simulation of novel editing concepts, to evaluate the potential value of those concepts.
- Performs analytics to simulate claims editing concepts against a variety of large claims datasets. Interprets requirements, writes SQL code, designs and populates reports, presents findings to stakeholders
- Performs assorted other analytics in support of the clinical department or other primary or secondary claims editing stakeholders. This often includes evaluating the frequency of novel scenarios that occur within large claims datasets
- Works on a variety of larger projects to support the broader team: Developing tools to monitor the data quality of our unique data assets; designing and building interactive dashboards for our external customers; building or enhancing self-service query engines to support our internal customers; running Benchmark reports that compare our data against industry-wide standards; and more. Builds new tools or develops processes that streamline or automate the fulfillment of external requests
- Receives the requirements of a request, works with stakeholders to clarify any ambiguities, performs the analysis, creates a report that documents the request and the results, and then presents their findings, for internal stakeholders the results are usually presented in Excel, for external stakeholders the presentation can be a combination of Excel and PowerPoint
- Bachelor’s Degree
- Experience with data analysis
- Experience with health insurance claims data including the unique elements of professional, and facility claims
- Experience with claims editing concepts and the claims adjudication cycle
- Advanced level of PL/SQL expertise and writing queries that will perform well in a “big data” environment. Experience creating complex join clauses, using set operations, performing aggregations, pivoting and unpivoting fields, and using “analytic functions” that use partitioning and windowing clauses.
- Relational database design experience
- Experience working with large data sets in Oracle / performance tuning
- Experience building, populating, and deploying interactive dashboards in Tibco Spotfire or similar tool
- R or Python (for graphing)
- MS Excel – functions, pivot tables, graphing
- Bachelor’s Degree in business, analytics, healthcare IT, finance
- Excellent verbal and written skills. Proven ability to communicate effectively with external customers, stakeholders, and cross-functional team members
- Ability to present complex analyses clearly and at a level of detail appropriate for the target audience.
- Rapid critical thinking skills and problem-solving skills
- Ability and willingness to learn and use new technologies
- Must be able to work independently, estimate work and provide estimated time of completion for their tasks, manage their workload, and provide status to stakeholders.
- Attention to detail and a commitment to quality is critical to success in this role
Working Conditions/Physical Requirements:
- General office demands
- Employees in roles that require travel will need to be able to qualify for a company credit card or be able to use their own personal credit card for travel expenses and submit for reimbursement.
- Flexible work environments
- Ready, Set, Grow Career Development Center & access to Change Healthcare University for continuous professional learning & development with more than 5,000 training assets
- Volunteer days, employee giving and matching gifts programs, community awards and dollars for doers, community partnerships
- Employee wellbeing programs and generous health plans
- Educational assistance programs
- US 401(k) or Group RRSP (Canada) savings plans with matching employer contributions
- Be sure to ask our Talent Advisors for more information on location specific benefits and paid time off policies
- Learn more at https://careers.changehealthcare.com
- *Eligibility for some benefits may be limited or not available for part-time employees, be sure to speak with your Talent Advisor.
Diversity and Inclusion:
- At Change Healthcare, we include all. We celebrate diversity and inclusivity, respect each other and value our unique experiences. By being our authentic selves, we bring different perspectives into our work and relationships.
- Business Resource Groups (BRGs) play a central role in advancing diversity and inclusion at Change Healthcare. They deepen our understanding of different cultures, people, and experiences, and help foster an inclusive workplace. Change offers eight (8) BRGs. Learn more at https://careers.changehealthcare.com/diversity
Feeling Inspired? Ready to #MakeAChange? Apply today!
California / Colorado / New Jersey / New York / Rhode Island / Washington Residents Only:
The applicable base pay for your state is listed below. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, ClaimsXten Portfolio offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with ClaimsXten Portfolio, you’ll find a far-reaching choice of benefits and incentives.The base pay range for this position is $81,630.00 - $202,200.00
Diversity, Equity & Inclusion:
•At Change Healthcare, we include all. We celebrate diversity and inclusivity, respect each other and value our unique experiences. By being our authentic selves, we bring different perspectives into our work and relationships.
•Business Resource Groups (BRGs) play a central role in advancing diversity and inclusion at Change Healthcare. They deepen our understanding of different cultures, people, and experiences, and help foster an inclusive workplace. Change offers eight (8) BRGs. Learn more at https://careers.changehealthcare.com/diversity
Feeling Inspired? Ready to #MakeAChange? Apply today!
COVID Vaccination Requirements
We remain committed to doing our part to ensure the health, safety and well-being of our team members and our communities. As such, some individuals may be required to disclose COVID-19 vaccination status prior to or during employment. Certain roles may require COVID-19 vaccination and/or testing as a condition of employment. Change Healthcare adheres to COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance.
ClaimsXten General Disclaimer
Change Healthcare is not affiliated with TPG Capital, TPG or the ClaimsXten Portfolio Business.Change Healthcare is providing talent sourcing and other people management administrative tools for the ClaimsXten Portfolio Business for a brief period of time.However, Change Healthcare has no role in the interviewing, selection, employment, or management of ClaimsXten applicants or employees.Though applicants may see the Change Healthcare logo and/or email addresses during the application process (and, if employed, during employment), Change Healthcare serves only an administrative role and is not the employer seeking to fill this role.ClaimsXten Portfolio Business makes all employment decisions concerning applicants.
Equal Opportunity/Affirmative Action Statement
Change Healthcare is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, genetic information, national origin, disability, or veteran status. To read more about employment discrimination protections under federal law, read EEO is the Law at https://www.eeoc.gov/employers/eeo-law-poster and the supplemental information at https://www.dol.gov/ofccp/regs/compliance/posters/pdf/OFCCP_EEO_Supplement_Final_JRF_QA_508c.pdf.
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Talent Acquisition Process
Once you apply for a job opening, the Sourcing Specialist or Talent Advisor will review your resume ensuring your background matches the minimum job requirements. Selected candidates will be invited for a phone screen.
Steps will vary by team, but typically include: Talent Advisor phone screen, hiring manager interview, and a combination of technical screens and panel interviews.
If you're selected, you can expect the Talent Advisor to reach out with specific offer details. During this stage you will be provided with an electronic offer letter and other new hire documents.
Once you've electronically signed your offer, our onboarding team will get you ready for Week 1 and set you up for success! Onboarding tasks may include a background check, drug screening, and other job specific requirements.
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