Medical Analyst Job Description
Medical analyst
provides technical, database management, and analysis support for key quality and medical/management initiatives involving disease management, provider profiling, case management, concurrent review, prior authorization, and other utilization and quality management functions.
Medical Analyst Duties & Responsibilities
To write an effective medical analyst job description, begin by listing detailed duties, responsibilities and expectations. We have included medical analyst job description templates that you can modify and use.
Sample responsibilities for this position include:
Create and run reports in Tableau
Improve data quality of the spend system
Guide new users to obtain access to the system
Continuously check the data in the system and correct any issues
Coordinate efforts of Procurement Team Members
Work with Information Technology Partners to resolve issues
Track open issues to resolution
Train new users on the system
Create reports for the Procurement Community
Perform second validation of discrepancy reason code assigned by the Discrepancy Analyst
Medical Analyst Qualifications
Qualifications for a job description may include education, certification, and experience.
Licensing or Certifications for Medical Analyst
List any licenses or certifications required by the position: CPC, CCS, RHIA, RHIT, APICS, CTR, NAMSS, OEA, AEO, CMA
Education for Medical Analyst
Typically a job would require a certain level of education.
Employers hiring for the medical analyst job most commonly would prefer for their future employee to have a relevant degree such as Bachelor's and Collage Degree in Education, Business, Statistics, Economics, Science, Management, Mathematics, Computer, Finance, Information Systems
Skills for Medical Analyst
Desired skills for medical analyst include:
Claim processing and claim policies and procedures
Computer entry and operations
Relational database concepts and designs
Medical terminology
Testing results and pharmacy data
Database concepts and designs
Tableau
Standard health care metrics for payer and provider reporting
Medical information operational experience
Look-up tables and macros
Desired experience for medical analyst includes:
Effective presentation of reporting and analytic results
Ability to interpret and scope customer (internal and external) requirements
Bachelor's degree in job related field plus one year of related experience
3-5 years experience performing complex business analysis and functional implementations
Proficient in the tools and techniques of business analysis
Proven progressive attitude toward skills improvement, independent thinking, and advanced technology
Medical Analyst Examples
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Medical Analyst Job Description
Job Description Example
Our company is growing rapidly and is looking to fill the role of medical analyst. We appreciate you taking the time to review the list of qualifications and to apply for the position. If you don’t fill all of the qualifications, you may still be considered depending on your level of experience.
Responsibilities for medical analyst
- Perform appropriate follow up with payor for payment as appropriate
- Escalate contract issues to the Supervisor
- Assess and drive continuous improvement in IIT/COOP/Disease Registry analysis and reporting through process efficiencies and increased data integration
- Partner with business owners in Medical Affairs Research & Development with preparation of quarterly forecasts and annual budgets
- Work with managers and billers of a hospital billing department to identify differences between how the Quadax proprietary medical claims processing software (Xpeditor) edits claims versus the hospital’s current EDI system
- Perform root cause analyses and analytic data mining to evaluate medical cost savings opportunities
- Develop cost-benefit analyses and savings models to project / measure the financial impact of initiatives
- Present analyses to appropriate stakeholders in an understandable manner in order to advance projects and transform data into actionable outcomes
- Prepare exhibits for presentation to key stakeholders throughout project lifecycle
- Serve as a key resource on critical issues
Qualifications for medical analyst
- Strong ability to communicate effectively in both oral and written forms
- Uses data and information to assist in decision making
- Experience working in healthcare in an office setting preferred
- Medical billing knowledge preferred
- Working knowledge of policies, practices and systems
- Full use and application of standard information technology and programming principles, theories, concepts and techniques
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Medical Analyst Job Description
Job Description Example
Our company is growing rapidly and is looking for a medical analyst. We appreciate you taking the time to review the list of qualifications and to apply for the position. If you don’t fill all of the qualifications, you may still be considered depending on your level of experience.
Responsibilities for medical analyst
- Collect quality related data via fax/mail/email and prep data for Quality Improvement team
- Identify appropriate sources of medical research, industry news, and competitive intelligence
- Conduct structured research within defined methodologies
- May collaborate with team members in Clinical Affairs, Marketing and Corporate Strategy to assemble actionable business information to support RFPs and government services programs (Medicare Advantage and Medicaid)
- May oversee content repository and develop new areas where the repository can be leveraged
- May administer document delivery and collection development
- Collaborate with Knowledge Services team and Information Services & Technology to implement technology solutions to manage knowledge assets compiled during surveillance activities
- Conduct or assist with information needs assessment of senior managers, clinical leadership, and clinical knowledge team, depending upon level
- Conduct service evaluation and process improvement
- Independently assesses the complaint to determine if a medical device report needs to be filed with various global regulatory agencies
Qualifications for medical analyst
- Act as a ‘product manager’ for their domain - going beyond simple requirements elicitation and defining solutions that anticipate future needs, leverage knowledge of where the industry is going, future proof our investments
- Provide strong support during the build process, overseeing development to ensure the solutions are built and will meet/exceed the needs of the business
- Facilitate the UAT process, ensuring the business fully understands the capabilities and tests the complete solution and data supporting it
- Lastly, the will define the user experience, ensuring field solutions not only work but they are easy to navigate and consume
- Business/Systems Analysis role on field Projects in the Biotech or Pharmaceutical industry is required
- Must understand the components of running a fiscally successful project
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Medical Analyst Job Description
Job Description Example
Our company is looking for a medical analyst. Please review the list of responsibilities and qualifications. While this is our ideal list, we will consider candidates that do not necessarily have all of the qualifications, but have sufficient experience and talent.
Responsibilities for medical analyst
- Keeps Team Manager informed verbally and in writing of activities and problems within assigned area of responsibility
- Documents receipt and contents of medical reports
- Data cleansing of detailed facility purchase histories for Medical Device service lines obtained through various resources
- Savings Opportunity Analysis for prospects and leads
- Support Senior Financial Analysts in both national and custom financial analyses
- Identifying and resolving data issues
- Monthly and Quarterly reporting of savings and tracking measures
- Develop and maintain effective, professional customer-facing reports
- Effective communication of results to finance team lead
- Reviewing price equitability of contract amendments for product adds and replacements
Qualifications for medical analyst
- Language capability is an Advantage (German, French, Dutch or Danish)
- 3+ years business experience preferably in the healthcare industry and/or a technical role
- Strong skills in analytical/problem solving and presentations
- Perform the traditional functions expected of a Business Analyst - document requirements, develop flow diagrams, and understand business processes surrounding medical data, reporting, and analytics
- Candidate must have experience in direct support of Bio/Pharma field force, ie
- Strong understanding of SFDC / Service Cloud is also a plus
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Medical Analyst Job Description
Job Description Example
Our company is looking to fill the role of medical analyst. If you are looking for an exciting place to work, please take a look at the list of qualifications below.
Responsibilities for medical analyst
- Interacts daily with both internal and external individuals
- Meets daily and monthly production and quality targets
- Monitors metrics and ROI benchmarks for medical plan, including health care trend in the US
- Conduct or support internal data gathering processes
- Monitoring and tracking clinical quality and productivity performance of the Medical Foundation
- This role requires strong knowledge of healthcare-specific business and healthcare service lines on the professional side, cost accounting principles and excellent business and financial modeling skills
- This position must be flexible, adaptive, self-directed, collaborative, able to prioritize while working on multiple projects simultaneously, and comfortable working in a matrix-style environment
- Coordinate special clinical studies related to focus areas identified for review
- Develop and maintain Medical and Pay Policies (HealthPlan coverage policies)
- Develop standard and ad~hoc report, and data validation related to monitoring and improving performance of shared savings and risk contracts with commercial and governmental health care payers
Qualifications for medical analyst
- Degree or equivalent related business experience
- CBAP certification is a plus, but not required
- 3+ years of experience working within a managed care organization, health insurer, or as a consultant, with experience on Medicaid and/or Medicare products
- BA/BS degree with a Master’s Degree preferred in Statistics, Mathematics, Computer Science, Business, Health Administration, or related field or equivalent experience
- Problem solving skills, including the ability to work independently and systematically analyze complex problems, draw relevant conclusions, and successfully devise / implement solutions calmly and effectively
- Experience mining large data sets, familiarity with Big Data mining tools is a plus
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Medical Analyst Job Description
Job Description Example
Our company is looking to fill the role of medical analyst. Please review the list of responsibilities and qualifications. While this is our ideal list, we will consider candidates that do not necessarily have all of the qualifications, but have sufficient experience and talent.
Responsibilities for medical analyst
- Be responsible for standard and ad-hoc report development, data validation, and new metric development related to monitoring and improving performance of shared savings and risk contracts with commercial and governmental health care payers
- Be responsible for developing metrics to successfully track improvement and will partner with key leadership and stakeholders to identify and achieve priorities, goals, and objectives
- Master's degree in economics, statistics, clinical informatics, finance, business or healthcare administration or equivalent combination of education and experience
- Minimum 2~5 years in analytical role with an analysis firm or large company utilizing heavy data management components and performing independent analysis
- Minimum 2 years experience in managed care, physician practice operations, employer health benefits analysis or healthcare analysis firm with heavy data management components
- Knowledgeable about both the clinical and financial sides of managed care, including capitation and pay~for~performance
- Update and maintain the existing network evaluation and pricing program
- Leverage all information available, both internally and externally, to ensure accuracy and consistency of network relativities
- Provide support on any projects related to enhancing the existing network pricing methodology
- Provide pricing support to UW and Distribution on case specific network pricing requests
Qualifications for medical analyst
- Proficiency in database applications such as Teradata, Cognos, MicroStrategy, Business Objects
- Degree in a health sciences, economics or related discipline
- Research and analysis skills required including
- Able to collaborate with project teams in multiple technical areas (programming, modeling, literature analysis)
- Three years of progressive experience in the compensation/personnel/payroll areas
- Bachelor's Degree, or equivalent experience, in Business Administration or related field