Sr. Cost of Health Care Strategy Analyst

Company Description

Why Wellmark: We are a mutual insurance company owned by our policy holders across Iowa and South Dakota, and we’ve built our reputation on over 80 years’ worth of trust. We are not motivated by profits. We are motivated by the well-being of our friends, family, and neighbors–our members. If you’re passionate about joining an organization working hard to put its members first, to provide best-in-class service, and one that is committed to sustainability and innovation, consider applying today! 

Learn more about our unique benefit offerings here. 

Job Description

Internal Job Title: Sr Network Innovation Analyst

The health care industry is evolving and Wellmark is working to help change it for the better. Help us lead the change as we build out our Network Analytics Team at Wellmark!

About the Role: Drive Wellmark’s value-based strategy by designing, implementing, and enhancing value-based payment and incentive models. Leverage multiple internal and external data sources to deliver strategic analysis, actionable recommendations, and performance dashboards that improve medical cost, quality, and provider outcomes. Ensure data integrity through quality assurance checks, and support total cost of care initiatives for the Network Performance team. Serve as a mentor and coach, developing tools and processes that modernize analytics, improve efficiency, and strengthen reporting capabilities.

About You: You are inquisitive and focused on making data-driven conclusions, decisions and recommendations to achieve business goals. You feel effective when you can extract, analyze, interpret and integrate data to monitor and implement strategic, innovative initiatives. In addition, you have a thorough understanding of contracting, claims payment procedures and payment policy. You have strong written and verbal communication skills that aid you in consulting, collaborating and effectively communicating complex concepts to varied audiences. You enjoy mentoring, coaching, sharing knowledge, and providing guidance to others, while building and maintaining collaborative relationships with internal and external stakeholders.

This position will work a hybrid schedule of at least 3 days in a Wellmark's Des Moines office (Tues-Thurs), with 2 days remote option (Mon and Fri).  

Qualifications

Required Qualifications:

• Bachelor's degree or direct and applicable work experience.
• 5+ years of experience:
  • Pulling reports, analyzing, and interpreting complex data – e.g., clinical outcomes, claims data, utilization trends, etc. Ability to interpret and integrate data, or perform statistical analyses and data modeling techniques.
  • Health insurance, health care, or related industry experience.
• Proficiency with Microsoft Office applications, including Excel. Ability to create or customize ad hoc reports and knowledge of formulas, vlookups, linking spreadsheets or data sources, data summarization/visualization, etc.
• Proficiency in SAS and SQL for data extraction, manipulation, and analysis and the technical aptitude to learn new data management and analysis tools or methodologies quickly.
• Strong consultation, relationship management, and critical thinking skills. Ability to develop business acumen and ask meaningful questions in order to effectively consult with and influence stakeholders.
• Strong written and verbal communication skills with the ability to communicate complex concepts to varied audiences. Ability to develop and deliver presentations.
• Attentive to details. Ability to collect, monitor, and assess the accuracy, validity, and integrity of data.
• Ability to educate stakeholders on complex, technical subjects.
• Experience coaching and mentoring others.
• Valid Driver’s License with intermittent travel, less than 5%.

Preferred Qualifications:

• Experience developing executive summaries.
• Have a passion for mentorship and coaching.
• Familiarity with SAFe Agile Methodology

Additional Information

Job Accountabilities:

a. Develop new value-based payment models and data analytics and reporting, using internal data sources and vendor relationships.

b. Provide actionable data and recommendations to health care organizations as it relates to medical cost and quality. The Sr. Analyst will collaborate with the Network Payment Strategy and Network Performance teams and will meet with value-based health care organizations to review performance and drive action plans that achieve cost of care, quality and financial performance.

c. Develop opportunity projections and det