Job Description

- Managed Care (Full-Time, Day Shift) - Our mission is to participate in Jesus Christ's ministry, bringing health, healing, and wholeness to humanity by creating a supportive faculty practice framework that allows Loma Linda University School of Medicine physicians and surgeons to educate, conduct research, and deliver quality health care with optimum efficiency. We aim to deploy a motivated and competent workforce trained in customer service and whole person care principles, providing safe, seamless, and satisfying healthcare encounters for patients while upholding the highest standards of fiscal integrity and clinical ethics. Our core values are compassion, integrity, humility, excellence, justice, teamwork, and wholeness. The Performance Analyst supports Managed Care leadership by providing data management and analytics related to the management of Medicare Advantage and commercial populations, along with associated contract performance. This role involves designing and implementing metrics to support operational and financial decision-making, preparing effective data displays and dashboards, tracking and updating RAF/Risk Adjustment scores, forecasting clinical and financial data impacts, and ensuring compliance with CMS and DMHC regulations, as well as health plan contractual reporting requirements. Performs other duties as assigned. Requirements include a Bachelor's Degree in business, healthcare analytics, or a related discipline, with a minimum of four years of experience in managed care data analytics and/or management. Alternatively, four additional years of experience can substitute for the degree. Essential skills include understanding of managed care data analytics such as capitation, utilization management, claims, case management, financial analysis, and HCC coding, along with knowledge of CMS and DMHC regulations. Proficiency in data management, MS Excel, report and graphics development, and analytics platforms is required. Ability to keyboard 40 wpm, operate basic office equipment, and use relevant software (Word, Excel, Outlook, PowerPoint) is necessary. The role demands the ability to work calmly under pressure, collaborate, think critically, manage multiple tasks, organize workload, problem-solve, and pay close attention to detail. Visual and auditory acuity sufficient for the position is also required. Our mission continues to be the teaching and healing ministry of Jesus Christ. Our core values are compassion, excellence, humility, integrity, justice, teamwork, and wholeness. #J-18808-Ljbffr Loma Linda University Health

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