Research Analyst

Job Title:

Local Research Analyst

Number of Positions:

1

Location:

DDMI - Nashville

Location Specifics:

Hybrid Position

Job Summary:

Must reside in Metropolitan Davidson County, Tennessee or a county contiguous to Metropolitan Davidson County, Tennessee.

At Delta Dental of Michigan, Ohio, and Indiana we work to improve oral health through benefit plans, advocacy and community support, and we amplify this mission by investing in initiatives that build healthy, smart, vibrant communities. We are one of the largest dental plan administrators in the country, and are part of the Delta Dental Plans Association, which operates two of the largest dental networks in the nation.

At Delta Dental, we celebrate our All In culture. It’s a mindset, feeling and attitude we wrap around all that we do – from taking charge of our careers, to helping colleagues and lending a hand in the community.

Position Description:

Supports local data needs for TennCare by generating various reports, providing assistances in reviews, and evaluating provider treatment patterns.  

• Acts as the liaison between business and technology teams to identify, diagnose and resolve complex business solutions in support of TennCare contract objectives.

• Provides expertise and assistance in provider post utilization review, establishing benchmarks for procedures prone to provider fraud and abuse that don't require prior authorization.

• Evaluates provider's treatment patterns and trends and identifies outliers.

• Responsible for generating daily, weekly, monthly, quarterly, and yearly reports required by the TennCare contract.

• Communicate statistical outcomes using visualization tools and ensure data integrity by improving the quality, completeness, and consistency of data.

• Builds and maintains relationships with healthcare providers.

• Addresses and resolves provider inquiries and issues.

• Provides specialized techniques in exploratory data analysis from various internal and external resources to build and support product and service offerings.

• Creates meaningful, data-driven solutions to new initiatives, opportunities, and challenges.

• Determines the approach and techniques necessary to accomplish objectives, including appropriate data selection and evaluation, analysis, testing, quality assurance, interpretation, and preparation of materials for internal/external review.

• Prioritizes business and information needs to generate reports, dashboards, and other visualizations to fit the technical understanding of internal and external audiences.

• May extract, develop, or maintain data from databases by creating new or altering existing SQL scripts and queries.

• Supports local data needs with backup support from the corporate office for more complicated analytic requests.

#LI-Hybrid

Minimum Requirements:

Position requires a bachelor’s degree in computer science, information systems, mathematics, business administration, or a related field and five years of experience performing data analysis in a business setting. Experience with Oracle-based systems and using PL/SQL, SAS and/or other querying languages to create and analyze data sets is also preferred. Experience with Python, R, HTML/CSS and understanding of TOGAF, Agile/Lean, Kimball methods, and UX also preferred. Will accept any suitable combination of education, training, or experience.

Position requires strong communication and interpersonal skills to effectively interact with healthcare providers and internal teams; ability to work efficiently with both structured and unstructured data sources; ability to analyze and interpret complex data sets, including identification of trends or patterns; ability to convey written and oral summaries of data analysis to clients, team members, and business leaders; ability to lead end-to-end data analysis projects; strong working knowledge of Microsoft Excel; ability to manage multiple tasks and prioritize effectively; and the ability to analyze and resolve complex problems, use independent judgment. Knowledge of healthcare regulations and standards is preferred.

The company will provide equal employment and advancement opportunity within the context of its unique business environment without regard to race, color, religion, gender, gender identity, gender expression, age, national origin, familial status, citizenship, genetic information, disability, sex, sexual orientation, marital status, pregnancy, height, weight, military status, or any other status protected under federal, state, or local law or ordinance.