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Healthcare Data Analysts
  • Data Analysis
  • Excel
  • Data Mining
Symetra
Enfield, CT 06082
135 days ago

Symetra has an exciting opportunity to join our team as a Healthcare Data Analyst!

About the Role


Our Healthcare Data Analyst will be responsible for reviewing and analyzing medical and pharmacy claims data to identify claims risk necessary to optimize the underwriting process. This position will also be responsible for creating and defining best practice standards for reviewing, analyzing and providing claims experience overview to the underwriters, nurses and management. Typical duties include data reporting, data analytics, and data mining, as well as coordinating with relevant departments to determine areas for analysis and the appropriate metrics to ensure data analysis is optimally useful. This position will leverage clinical expertise and system data manipulation skills in order to review large, complex reports and identify individuals with potentially catastrophic claims.

Your responsibilities

  • Prepare “Shock Claims Summaries” - Review underwriting group reports in order to identify and extract data corresponding only to individuals diagnosed with potentially catastrophic conditions. Prepare “Shock Claims Summary”, which provides a sequential synopsis of each individual’s conditions and treatment (ICD-9 or ICD-10 codes), including the range of the dates of service on the report, the treatment provided (based on CPT codes) and the corresponding costly pharmacy drugs prescribed (J-Codes). For each group, the data corresponding to the individuals who are identified as representing potentially significant risk needs to be isolated and presented to Underwriting in a “Shock Claims Summary” format. The Shock Claims Summary will be forwarded to the underwriters and the medical risk consultants for review as part of the stop-loss underwriting risk assessment process.
  • Customized report review guidelines - Create, document, update and publish the step-by-step guidelines designed to facilitate the consistent review of the underwriting reports. Customize the guidelines in order to capture relevant data for the various report formats (e.g. UHC, Aetna, Cigna, BCBS Plans, etc.)
  • Customer Service Goal Details: Interact with Underwriting and MRCs in order to discuss significant risk findings on the new and renewal business experience reports.
  • Special projects/assignments - Works on special assignments, such as testing of the ESL application enhancements, conduct annual “laser project” analysis, etc.

Your education, experience and skills

  • 3-5 years experience in a healthcare related (hospital, managed care, medical group) analytic or reporting environment
  • Interact with Underwriting and MRCs in order to discuss significant risk findings on the new and renewal business experience reports.
  • Special projects/assignments - Works on special assignments, such as testing of the ESL application enhancements, conduct annual “laser project” analysis, etc.
  • Speed and accuracy in Excel and report data manipulation
  • Precise attention to detail
  • Ability to prioritize and manage time and deadlines efficiently
  • Self-starter with an ability to work independently
  • Ability to create new processes
  • Collaborative, ability to work across teams
  • Able to communicate with individuals at all levels

What we offer you

We don’t take a “one-size-fits-all” approach when it comes to our employees. Our programs are designed to make your life better—both at work and at home.
  • Flexible work and telecommute arrangements
  • Wellness program offering employees a variety of resources designed to assist you in reaching and maintaining your optimum health
  • Paid time away options to accommodate your needs and life’s events, including vacation (our favorite), illness, caring for a family member, volunteering, the birth or adoption of a child, the loss of a family member and more
  • Ongoing learning and skills development through our college tuition assistance, professional education certification programs and more
  • Plan for your future with our 401(k) plan and take advantage of immediate vesting and company matching up to 6%
  • Give back to your community and double your impact through our company matching and/or participate in our company-wide week of service each June
  • Want more details? Check out our Symetra Benefits Overview

In a complex industry, we strive for clarity.

Symetra is a dynamic and growing financial services company with 60 years of experience and customers nationwide. In our daily work delivering retirement, employee benefits, and life insurance products, we're guided by the principles of VALUE, TRANSPARENCY AND SUSTAINABILITY. That means we provide products and services people need at a competitive price, we communicate clearly and honestly so people understand what they're getting, and we build products that stand the test of time. We work hard and do what's right for our customers, communities and employees. Join our team and share in our success as we work toward becoming the next national player in our industry.
Learn more about our careers at www.symetra.com/careers

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