Job Description The Healthcare Statistical Analyst performs technical services within the actuarial or risk adjustment department that support the Health Plans operations, monitoring and maintaining financial solvency through the understanding of current data & environment and modeling of future events. This role interacts with internal and external partners and regulatory agencies, monitors trends, brings forward opportunities and insights found in the data to the applicable audiences, and supports leadership by providing statistical information and analysis needed to make informed decisions. The analyst identifies trends and utilizes data mining techniques, including the development of advanced predictive models. Essential Accountabilities All Levels Update existing and aid in the creation of new analysis pertaining to benefit designs, claims experience, Value Based Payment (VBP) programs, and valuation of internal and externally led claims savings and risk adjustment initiatives. Maintain existing processes including reserve programs, pricing files, benefit relativity tables, trend analysis, risk score analysis, VBP and vendor financial settlements, ROI work; create and maintain appropriate documentation for work. Assist with the development of projections (financial, claims, risk score, trend, utilization, savings, etc.), unpaid claim liability estimates and identification of areas for savings. Compile and analyze data to draw conclusions, support data quality, and provide recommendations. Propose and assist in developing process improvements utilizing system and software applications to full potential and participate in activities and projects as directed. Consistently demonstrate high standards of integrity by supporting the lifetime healthcare company’s mission and values, adhering to the corporate code of conduct, and embodying the Lifetime Way values and beliefs. Maintain high regard for member privacy in accordance with corporate privacy policies and procedures. Ensure regular and reliable attendance. Perform other functions as assigned by management. Level II (in addition to Level I Accountabilities) Conduct analyses for and communicate with other departments on various initiatives. Assist in the development of analyses concerning complex issues & trends, coordinating with staff. Participate in reviewing and evaluating emerging trends in healthcare, establishing reserves and producing financial analysis. Recommend appropriate applications and process changes to existing and new analysis. Reconcile Data Warehouse data with corporate financials or encounter submissions and develop corrective action regarding Data Warehouse integrity issues. Initiate and lead efforts to improve data capabilities and the quality of department analysis and reporting. Independently ideate process improvements and recommend changes in process to direct leadership. Create and maintain documentation related to data analysis, data models, and data mapping, including technical documentation, process documentation and training materials. Draw together facts and input from a variety of data sources. Level III (in addition to Level II Accountabilities) Review and ensure pricings are consistent with established profitability targets for relevant business segments. Research and analyze data across complex data ecosystems, including operational and analytical data platforms, to develop insightful and effective reporting and dashboards. Demonstrate keen judgment on involved and complex assignments; devise methods and procedures to meet unusual conditions and make original contributions to solving very difficult problems. Problem solving is complex and involves critical issues. Develop analyses concerning complex issues and trends, coordinating with several different disciplines and staff. Lead and support departmental projects. Provide effective technical advice and support to assist management in meeting corporate goals and identifying strategy, involving other departmental areas as needed. Level IV (in addition to Level III Accountabilities) Recommend departmental annual performance goals. Offer strategic recommendations on the analysis of data, data collection, and integration using the knowledge of best practices and business requirements. Conduct exploratory, descriptive, and inferential data analysis using statistical and machine learning techniques. Represent the department on special projects involving other areas of the company or external constituents. Partner with and lead projects including stakeholders from a variety of departments. Interpret how regulatory changes affect health plan and develop impact analyses. Collaborate with senior leadership in meeting corporate goals and strategic decision making. Minimum Qualifications All Levels Bachelor’s Degree in Math, Statistics, Economics, Medical Informatics, Actuarial Science or relevant field required. One (1) year of related experience preferred. Strong analytical, verbal, and written communication skills. Strong interpersonal skills with demonstrated ability and willingness to collaborate with other team members. Ability to prioritize, multitask, and maintain multiple simultaneous projects. Intermediate technical skills, including proficiency in Microsoft Office Suite. Programming skills in SQL, SAS, VBA, or similar preferred. Level II (in addition to Level I Qualifications) Two (2) years related experience. Strong understanding of health insurance & health insurance products, managed care, accounting principles, competitive market, legislative environment, and any regulatory issue affecting the health plan. Ability to work independently, with high level of self‑motivation to improve processes. Proficient programming skills in SQL, SAS, VBA, or similar preferred. High level understanding of non‑Actuarial functions such as Rating & Underwriting, Finance, Provider Contracting, Analytics & Data Technology, Population Health Engagement, Marketing & Sales, etc., and how they impact health plan operations and financials. Level III (in addition to Level II Qualifications) Four (4) years related experience. Ability to perform complex modeling independently. Strong ability to recognize and automate repetitive tasks. Ability to communicate analytical findings at the appropriate level of detail for receiving audience. Demonstrated experience leading projects or process improvement initiatives. Ability to write and communicate complex concepts. Level IV (in addition to Level III Qualifications) Six (6) years related experience. Advanced understanding of non‑Actuarial functions such as Rating, Underwriting, Accounting, Provider Contracting, Network Management, Product Development, Medical Management, etc., and how they impact health plan operations and financials. Advanced ability to independently communicate analytical findings at the appropriate level of detail for receiving audience. Strong ability to independently write, communicate and present complex concepts to both actuarial and non‑actuarial audiences. Physical Requirements Ability to work while sitting and/or standing at a workstation viewing a computer and using a keyboard, mouse and/or phone for three (3) or more hours at a time. Ability to travel across the health plan service region for meetings and/or trainings as needed. Equal Opportunity Employer All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. Compensation Range(s) Level I: Grade E1 – Minimum $60,410 – Maximum $84,000 Level II: Grade E3 – Minimum $60,410 – Maximum $106,929 Level III: Grade E5 – Minimum $71,880 – Maximum $129,384 Level IV: Grade E6 – Minimum $79,068 – Maximum $142,322 The salary range indicated in this posting represents the minimum and maximum of the salary range for this position. Actual salary will vary depending on factors including, but not limited to, budget available, prior experience, knowledge, skill and education as they relate to the position’s minimum qualifications, in addition to internal equity. The posted salary range reflects just one component of our total rewards package. Other components may include participation in group health and/or dental insurance, retirement plan, wellness program, paid time away from work, and paid holidays. Please note that there may be an opportunity for remote work within all jobs posted by the Excellus Talent Acquisition team. This decision is made on a case‑by‑case basis. #J-18808-Ljbffr