13 Healthcare jobs in Pinellas Park

**JOB DESCRIPTION**
**Job Summary**
This Sr. Analyst, Healthcare Analytics role will be responsible for work around Program Valuation on Molina's Risk Adjustment Actuarial team. Responsibilities include research, analysis and modeling of complex healthcare claims data, pharmacy data, lab data, and Risk Adjustment submissions data to evaluate healthcare intervention program performance. Develops and presents Risk Adjustment intervention ROI, incremental conditions captured, and other program performance reports including forecasts and makes recommendations based on relevant findings. Performs Health Plan strategic analysis and planning and coordinates across business units on Risk Adjustment Program Valuation and Strategic/Scoreable Action Items (SAIs) to meet business needs. Performs analysis across multiple states and lines of business (Medicare, Medicaid, Marketplace ACA).
**KNOWLEDGE/SKILLS/ABILITIES**
+ Compiling and organizing health care data using Databricks and Spark SQL, Notebooks, Workflows, Repositories, SQL Server Stored Procedures, SQL Server Integration Services (SSIS), and other analytic / programming tools as needed
+ Reporting includes Risk Adjustment program performance metrics, risk score and revenue impact, tracking of strategic/scorable action items, annual and quarterly forecasts, and regular deep dives to drive improvement in financial results
+ Take ownership with root cause analysis to maintain high integrity data and processes to minimize discrepancies and gaps
+ Create databases and reporting dashboards for monitoring, tracking and trending based on project specifications and applies automation as appropriate
+ Complete analysis and forecasting of risk adjustment intervention program values
+ Develop and demonstrate proficiency in running all applicable risk models including the various CMS models for Medicare Advantage members, the HHS model for Commercial ACA members, the CDPS model for Medicaid members, and others as needed
+ Must have a strong attention to detail and knowledge of data structure and programming
+ Performing financial analysis to assist in delivering optimal health care management and decision making
+ Understanding and applying data storage and data sharing best practices
+ Converting data into usable information that is easy to understand and provides insights needed to support strategic investment decisions
+ Research and develop reports and analyses for senior management and effectively and concisely communicate results and key takeaways
+ Collects and documents report / programming requirements from requestors to ensure appropriate creation of reports and analyses. Uses peer-to-peer review process and end-user consultation to reduce errors and rework
+ Practice strong judgement in carrying out work independently, consult with experts as needed and use available resources and reports to critique results
+ Manage multiple projects and consistently deliver results on time in a fast-paced environment with changing priorities
**JOB QUALIFICATIONS**
**Required Education**
Bachelor's Degree in Finance, Economics, Computer Science
**Required Experience**
+ 5-7 years increasingly complex database and data management responsibilities
+ 5-7 years of increasingly complex experience in quantifying, measuring, analyzing, and reporting financial/performance management metrics
+ Demonstrate Healthcare experience in Quantifying, Measuring and Analyzing Financial and Utilization Metrics of Healthcare
+ Advanced knowledge of SQL
+ Proficient in Excel and visualization tools such as Power BI, Tableau, or similar
**Preferred Experience**
Preferred experience in Medical Economics and Strong Knowledge of Performance Indicators:
+ Proactively identify and investigate complex suspect areas regarding risk adjustment initiatives, risk score lift, conditions captured, and program value
+ Initiate in-depth analysis of the suspect/problem areas and suggest a corrective action plan
+ Apply investigative skill and analytical methods to look behind the numbers, assess business impacts, and make recommendations through use of healthcare analytics, predictive modeling, etc.
+ Analysis and forecasting of program value and underlying population trends in risk adjustment to provide analytic support for finance, pricing and actuarial functions
+ Healthcare Analyst I or Financial/Accounting Analyst I experience desired
+ Multiple data systems and models
+ Data modelling and BI tools
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $77,969 - $155,508 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

**JOB DESCRIPTION**
**Job Summary**
Focuses on process improvement, organizational change management, project management and other processes relative to the business. Project management includes estimating, scheduling, costing, planning, and issue/risk management.
**KNOWLEDGE/SKILLS/ABILITIES**
+ Proven depth of understanding and demonstrable results for effective management of intermediate to large-scale projects, using prescribed approach(as). Solid knowledge of methods and techniques involved in project management initiatives.
+ Work with IT and business teams to set up/ amend new/ existing healthplans and new lines of business.
+ Must have experience in merger and acquisitions
+ Familiarity with SDLC.
+ Must have strong experience in Jira and smartsheets is preferred
+ Knowledge in Medicare, Medicaid and Marketplace is highly preferred.
+ Able to develop detailed project plans, communication plans, schedules, role definition, risk management and assumptions.
+ Complete mastery of standard applications and project specific software. Able to learn new software with little to no instruction within a short timeframe and instruct others on its functionality.
+ Identifies problems and anticipates potential problems. Ability to present alternatives to manage/overcome obstacles.
+ May consultant with higher level project management staff and may refer to established procedures and/or prior experience to determine appropriate and timely action. Projects may have moderate cross functional impact and team organization.
**JOB QUALIFICATIONS**
**Required Education**
Bachelor's degree or equivalent combination of education and experience and at least 1 PM course required
**Required Experience**
2-4 years of relevant work experience in business, engineering, or a related field in lieu of degree acceptable.
**Preferred Education**
Additional formal training in PM preferred.
**Preferred License, Certification, Association**
PMP or Six Sigma Green Belt Certification desired.
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $77,969 - $115,000 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

**Job Summary**
Responsible for multiple Enrollment internal business projects and programs involving department or cross-functional teams of subject matter experts, delivering products through the design process to completion. Plans and directs schedules as well as review enhancement ROI. Candidate must have strong analytic, organizational skills and the ability to independently resolve issues and remove hurdles. This is a hybrid role that requires Program Management, System Analyst and Sr. Business Analyst skills. Responsibilities include troubleshooting, analyzing, managing assignments, assisting team members, oversight of vendor projects, reviewing team outputs, review of deployment request and post deployment monitoring.
Building and maintaining strong relationships and proactive processes are key to the success of this team. The selected candidate would act as the liaison between the business, vendors , IT, and support Program Managers and Business Analyst in a subject matter expert capacity. May engage and oversee the work of external vendors. Coordinates with business analyst, IT and business areas, provides and reviews requirements and test results.
Knowledge/Skills/Abilities
+ Independently manage and deliver Enrollment Enterprise wide project initiatives from inception through delivery
+ Subject matter expert of enrollment to Program Managers and Analyst and in functional areas (Inbound and Outbound)
+ Communicate and collaborate with Operations, Health Plans and Leadership to analyze and transform needs and goals into functional requirements
+ Develops, defines, and executes plans, schedules, and deliverables. Monitors programs from initiation through delivery
+ Identify root cause, function and process improvement opportunities that are critical to effective outcome
+ Leads programs to meet critical needs. Including but not limited to BRD reviews, logic changes, root cause analysis, etc.
+ Works with operational leaders within the business to provide recommendations on opportunities for process improvements
+ Collaborate with Other Teams within Molina to deliver End to End for any process within Enrollment Accounting Team
+ Active collaborator responsible for operation projects and programs involving enrollment and eligibility
+ Works with cross-functional teams and IT and business subject matter expert and to deliver products from design to completion
+ Subject matter expert of enrollment and provides knowledge and feedback to ensure regulatory and Addresses health plan concerns within Enrollment Operations
+ Researches, interpret, define and summarize enhancement recommendations
+ Provides health plan requirement recommendations
+ Responsible for managing deliverables, improving performance, training needs, support to other business units
+ Strong business knowledge related to Medicaid and Medicare lines of business
+ Reviews enrollment issue trends and provides long term solutions as needed
+ Manages, creates and communicates status reports
+ Ensures compliant with regulatory and company guidelines, including HIPAA compliance
+ This position primarily focuses on project/program management related to the business projects, rather than the technical application projects
+ Focuses on process improvement, organizational change management, program management and other processes relative to the business
+ Participate and lead brainstorming sessions to develop new concepts to build efficiencies
+ Ideally possess minimum of 5 years' experience with eligibility processing, including; eligibility Applications and Files
+ Extensive knowledge in health insurance
+ Knowledge of enrollment files, including extracts
+ Program Manager experience
+ Sr. Business or System Analyst experience
+ Process Improvement Experience.
**JOB QUALIFICATIONS**
**Required Education**
Bachelor's Degree or equivalent combination of education and experience
**Required Experience**
7-9 years
**Required License, Certification, Association**
PMP Certification (and/or comparable coursework)
**Preferred Education**
Graduate Degree or equivalent combination of education and experience
**Preferred Experience**
10+ years
**Preferred License, Certification, Association**
Six Sigma Black Belt Certification, ITIL Certification desired
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $77,969 - $171,058 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

**We're unique. You should be, too.**
We're changing lives every day. For both our patients and our team members. Are you innovative and entrepreneurial minded? Is your work ethic and ambition off the charts? Do you inspire others with your kindness and joy?
We're different than most primary care providers. We're rapidly expanding and we need great people to join our team.
The Membership Growth Consultant (MGC) is an outside healthcare sales representative who's responsible for generating sales leads and membership by nurturing productive relationships with senior citizens, key local community partners and senior-focused businesses to enroll new patients to ChenMed. MGC is the first of three separate tiers as part of the overall MGC Success Plan and growth career path at ChenMed. The incumbent in this role is developing skills to arrange, design, and orchestrate sales events and to develop fun and cost-effective techniques to keep senior participation and satisfaction high, in part to drive referral sales from satisfied patients to help fuel membership growth. He/She learns to effectively communicate the ChenMed/JenCare value proposition at community events.
**ESSENTIAL JOB DUTIES/RESPONSIBILITIES:**
**COMPETENCIES:**
+ Begins to nurture, build and cultivate direct-to-seniors and business-to-business partnerships to generate new patient opportunities year-round.
+ Meets with individual seniors and groups in their homes, workplaces, houses of worship, senior centers or living communities to share the ChenMed value proposition.
+ Start planing, coordinating and executing local events within the community (e.g., information tables, health fairs, doc talks, etc.) to help reach our ideal patients (i.e., medically underserved, Medicare-eligible seniors, age 55 and older).
+ Start cultivateing strong relationships with health plan agents, individual insurance agents, social workers, case workers, senior housing managers, senior centers and related community providers to keep ChenMed/JenCare Medical Centers as their top provider choice for senior healthcare when referring patients to a primary care physician.
+ Partners with community officials, businesses and senior outreach programs to develop initiatives that will appropriately drive new patient growth.
+ Schedules one-on-one sales meetings, referral relationships with Plan agents, independent brokers and the senior community to delivers solutions on immediate customer requests. Manages vendors as related to event planning and negotiating contracts with venues where events are taking place.
+ Ensures insurance agents and/or brokers are invited to community events to ensure timely patient assignment to ChenMed/JenCare Medical Centers.
+ Learns to use marketing and sales tools to identify solutions and sell to new customers. Maintains up-to-date client information in designated customer relationship management (CRM) tool (i.e., SalesForce). Utilizes CRM tool to document interactions with clients and ensures effective management of leads.
+ Provides monthly activity calendar reflecting community access points and new tabletop venues. Creates penetration plans and initiatives in key target markets and channels.
+ Recovers dormant customers via sales tools and marketing campaigns.
+ Drives new member growth by appropriately educating potential patients on our value proposition and healthcare model. Delivers prescribed presentation in front of large audiences.
+ Develops distribution channels to support new patient enrollment growth. Uses all sales tools provided to ensure efficiency and collection of pertinent data.
+ Partners with sales leadership to improve effectiveness of engagements with distributors, vendors and community partners.
+ Builds trusting relationships with brokers/insurance agents/case workers/third party vendors associated with seniors with supervision Develops and executes specific broker and partner strategies and plans.
+ Engages with new patients through and beyond their first appointment. Maintains relationships with enrolled patients to positively impact retention. Helps address and resolve customer complaints and issues as required.
+ Performs other related duties as assigned.
**Instills trust**
Gaining the confidence and trust of others through honesty, integrity, and authenticity
+ Follows through on commitments
+ Is seen as direct and trustful
+ Keeps confidences
+ Practices what he/she preaches
+ Shows consistency between words and actions
**Results driven**
Consistently achieving results, even under tough circumstances
+ Has a strong bottom-line orientation
+ Persists in accomplishing objectives despite obstacles and setbacks
+ Has a track record of exceeding goals successfully
+ Pushes others
**Action oriented**
Taking on new opportunities and tough challenges with a sense of urgency, high energy, and enthusiasm
+ Readily acts on challenges, without unnecessary planning.
+ Identifies and seizes on new opportunities
+ Displays a can-do attitude in good and tough times
+ Steps up to handle tough issues
**Effective communication**
Developing and delivering multi-mode communications that convey a clear understanding of the unique needs of different audiences
+ Is effective in a variety of communication settings: one-on-one, small and large groups, or among diverse styles and position levels
+ Attentively listens to others
+ Adjusts to fit the audience and the message
+ Provides timely and helpful information to others across the organization
+ Encourages the open expression of diverse ideas and opinions
**Resiliency**
Rebounding from setbacks and adversity when facing difficult situations
+ Is confident under pressure
+ Handles and manages crises effectively
+ Maintains a positive attitude despite adversity
+ Bounces back from setbacks
+ Grows from hardships and negative experiences
**Networking**
Effectively building formal and informal relationship networks inside and outside the organization
+ Builds strong formal and informal networks.
+ Maintains relationships across a variety of functions and locations
+ Draws upon multiple relationships to exchange ideas, resources, and know-how
**Customer focus**
Building strong customer centric relationships and delivering customer-centric solutions
+ Gains insight into customer needs
+ Identifies opportunities that benefit the customer
+ Builds and delivers solutions that meet customer expectations
+ Establishes and maintains effective customer relationships
**Persuasiveness**
Using compelling arguments to gain the support and commitment of others
+ Positions views and arguments appropriately to win support
+ Convinces others to take action
+ Negotiates skillfully in tough situations
+ Wins concessions without damaging relationships
+ Responds effectively to the reactions and positions of others
**KNOWLEDGE, SKILLS AND ABILITIES:**
+ High business acumen and acuity
+ Exceptional organizational skills with the ability to manage multiple priorities in a fast-paced work environment
+ Demonstrated knowledge ofnegotiation, probing skills, closing skills and handling objections
+ Detail-oriented and proficient in MS office (PowerPoint, Excel, Word, and Outlook), CRM tools (Salesforce) plus a variety of other word-processing, spreadsheet, database, e-mail and presentation software
+ Excellent interpersonal and problem solving skills. Must have the patience and ability to engage customers in conversation
+ Excellent written and verbal communication skills, including a clear, confident speaking voice and a friendly rapport with customers. (e.g., pitch letters, outbound calls, effective one-on-one meetings, group presentations, etc.)
+ Must have the ability to be flexible and creative in dealing with customers. Positive attitude and the ability to attract patients with a warm, gentle disposition as it relates to our target market and their caregivers. Must be persuasive and highly motivated to make sales, with the ability to close sales without being perceived as pushy
+ Good keyboarding skills are needed. Ability to accurately type a significant number of words per minute
+ Spoken and written fluency in English
+ Bilingual is a plus
+ Ability and willingness to travel locally, regionally and nationwide up to 75%; work is primarily conducted off ChenMed premises
+ This position required use and exercise of independent judgment
**EDUCATION AND EXPERIENCE CRITERIA:**
+ High School Diploma or GED required. Bachelor's degree in Marketing, Business Administration or a related field preferred **OR** additional combination of formal education, training and experience above the minimum will be considered in lieu of the education on a year-for-year basis.
+ A minimum of 2 years of successful sales experience is required. Working with seniors a plus, as is a general understanding of Medicare Advantage
+ A minimum of 2 years of business-to-business experience or equivalent management experience preferred
+ Relevant sales experience with establishing and maintaining relationships with business/vendor partners
+ Experience in telesales to input sales data into a computer while on the telephone with a customer
+ This position requires possession and maintenance of a current, valid Driver's License
We're ChenMed and we're transforming healthcare for seniors and changing America's healthcare for the better. Family-owned and physician-led, our unique approach allows us to improve the health and well-being of the populations we serve. We're growing rapidly as we seek to rescue more and more seniors from inadequate health care.
ChenMed is changing lives for the people we serve and the people we hire. With great compensation, comprehensive benefits, career development and advancement opportunities and so much more, our employees enjoy great work-life balance and opportunities to grow. Join our team who make a difference in people's lives every single day.
Current Employee apply HERE ( Contingent Worker please see job aid HERE to apply
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