Sr. Analyst, Health Plan Data & Compliance

Job Description

The Position

Senior Analyst – Health Plan Data and Compliance – US Location

About You

We are looking for someone who has a passion for using data to improve quality healthcare access and outcomes for our employees and their families.  You will use strong technical skills that enable the evaluation and visualization of employee health trends and clinical program outcomes to recommend and implement solutions.  To be successful, you must be curious, willing to embrace new ideas, thrive in a fast-paced and frequently changing environment, and be comfortable navigating ambiguity.

About the Job

The Senior Analyst will be responsible for claims data analysis, health plan compliance, and some vendor and project management that will help shape and drive the U.S. benefits strategy.  This role will require working closely with vendor partners, particularly to drive accountability related to fiduciary diligence and compliance.

Responsibilities

• Leverages population health data to develop reporting and dashboards. Makes data-driven recommendations that shape Organon’s medical and prescription drug strategy, improve health outcomes, and reduce costs

• Uses knowledge of claims data to establish a reasonable cost baseline across procedures, providers, prescriptions, and sites of service, highlighting those that are low value and recommending actionable steps to steer members to higher value care

• Applies a deep understanding of federal regulations, including but not limited to ERISA, CAA, and MHPAEA to facilitate continued fiduciary compliance

• Identifies potential programs that align to the U.S. benefits strategy and supports integration into Organon’s benefits ecosystem

• Establishes efficient payment integrity processes and manages their ongoing cadence

• Facilitates meetings of Organon’s U.S. fiduciary committee

• Maintains professional, collaborative relationships with Organon’s vendor partners centered on transparency and accountability

• Supports RFPs for existing and new services

• Responsible for updates to SPDs, SMMs and distribution of all required notices to employees

• Provides backup support for retirement plan compliance and administration

Required Education, Experience and Skills

• Bachelor’s degree

• At least 5 years in a role that requires using data to improve health outcomes

• Experience creating data visualizations in Tableau

• Ability to think both critically and innovatively while challenging traditional healthcare models

• Ability to work in a fast-paced environment, navigate ambiguity, and embrace frequent change

• Problem-solving and learning mindset

• Positive, team-oriented attitude

Preferred Education, Experience and Skill

• Master’s degree in public health or related field

• Working knowledge of employer-sponsored or other commercial health plans

• Familiarity with commonly used CPT, ICD-10, and HCPCS codes

Who We Are:

Organon delivers ingenious health solutions that enable people to live their best lives. We are a $6.5 billion global healthcare company focused on making a world of difference for women, their families and the communities they care for. We have an important portfolio and are growing it by investing in the unmet needs of Women’s Health, expanding access to leading biosimilars and touching lives with a diverse and trusted portfolio of health solutions.  Our Vision is clear: A better and healthier every day for every woman.

US and PR Residents Only

For more information about personal rights under Equal Employment Opportunity, visit:

EEOC Poster