Fidelis Care is proud to provide quality, affordable health coverage for more than 2 million members, at all stages of life.

At Fidelis Care, we’re dedicated to serving residents of New York State who need quality, affordable health coverage. Grassroots outreach - from inner-city neighborhoods to the most rural towns - is central to our mission. From provider offices, to schools, churches, food pantries, and community agencies, Fidelis Care works closely with hundreds of partners to reach local residents in need and to be a resource in our community.

Fidelis Care provides coverage through Child Health Plus, Essential Plan, Medicaid, Health and Recovery Plan, Qualified Health Plans, Managed Long Term Care, and Medicare and Dual Advantage Plans.

Position Purpose Analyze integrated and extensive datasets to extract value, which directly impacts and influences business decisions. Work collaboratively with key business stakeholders to identify areas of value, develop solutions, and deliver insights to reduce overall cost of care for members and improve their clinical outcomes.

This is a remote position.

• Interpret and analyze data from multiple sources including claims, provider, member, and encounters data. Identify and assess the business impact of trends
• Develop, maintain, and troubleshoot complex scripts and reports developed using SQL, Microsoft Excel, or other analytics tools
• Contribute to the planning and execution of large-scale projects with limited direction from leadership
• Assist in the design, testing, and implementation of process enhancements and identify opportunities for automation
• Identify and perform root-cause analysis of data irregularities and present findings and proposed solutions to leadership and/or customers
• Manage multiple, variable tasks and data review processes with limited supervision within targeted timelines and thrive in a demanding, quickly changing environment
• Apply expertise in quantitative analysis, data mining, and the presentation of data to see beyond the numbers and understand how customers interact with analytic products
• Partner cross-functionally at all levels of the organization and effectively, both verbally and visually, communicate findings and insights to non-technical business partners
• Independently engage with customers and business partners to gather requirements and validate results
• Communicate and present data-driven insights and recommendations to both internal and external stakeholders, soliciting and incorporating feedback when required
• Provide technical guidance to junior analysts

Education/Experience

• Bachelor’s degree in business, economics, statistics, mathematics, actuarial science, public health, health informatics, healthcare administration, finance or related field or equivalent experience.
• Master's degree preferred.
• 4+ years of experience working with large databases, data verification, and data management or 2+ years of IT experience.
• Healthcare analytics experience preferred.
• Working knowledge of SQL/querying languages.
• Preferred knowledge of programmatic coding languages such as Python and R. Knowledge of statistical, analytical, or data mining techniques including basic data modeling, trend analysis, and root-cause analysis preferred.
• Preferred knowledge of modern business intelligence and visualization tools including Microsoft PowerBI.

Provider

• Experience in provider contracting, claims pricing, financial reporting/analysis, data modeling, statistical modeling, data science, or geospatial/reimbursement analysis preferred

Clinical

• Experience in public health (epidemiology, biostatistics), population health, social determinants of health, data science, social science, or geospatial/ROI/financial analysis preferred

Tools & Technology

• Experience with report/dashboard development, data/report automation, self-service capabilities, data design and integration, or data quality and governance preferred

Regional and HBR Analytics

• Experience in emerging trend analysis, financial modeling, claims pricing, contract/network analysis, and/or ROI evaluation preferred. Familiarity with claims payment, utilization management, provider/vendor contracts, risk adjustment for government sponsored healthcare desired.