Company Statement

Connecticare is a leading health plan in the state of Connecticut and a subsidiary of EmblemHealth, a health and wellness company that provides insurance plans, primary and specialty care, and wellness solutions.  WellSpark is a digital wellness company and national subsidiary of EmblemHealth that offers a full suite of products and solutions to reward people for healthy behaviors.

 

To protect the health and safety of our workforce, members, patients, and the communities we serve, the EmblemHealth family of companies require all new employees to be fully vaccinated for COVID-19. Exemption/reasonable accommodations may be granted because of 1) a qualifying medical condition or disability that makes getting the vaccine unsafe for the individual, or 2) objection on the basis of sincerely held religious beliefs and/or practices.
 

Government Programs Business Analysis Manager

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Manager & Professional
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EmblemHealth
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Monitor operational performance of Government Programs/ Products (Medicare and Medicaid) to ensure that each product is performing as expected. Work with other business areas across the organization to track and manage various Government Program-specific initiatives.Manage the performance of individual Government  products designed to drive membership growth/retention and operating margin, through analysis and problem solving. Develop appropriate processes are in place to capture sales activities related to retention and medical initiatives for cost savings. Drive the development of requirements for new processes to support operational effectiveness and efficiency for Medicare and Medicaid.

Responsibilities:

  • Provide analytics and reporting requirements for all business areas across Government Programs, i.e. sales, retention, product management, medical management, and network management.
  • Produce Medicaid and Medicare dashboards
  • Analyze enrollment and disenrollment to provide leadership with insight into enrollment and disenrollment trends.
  • Produce reports to support product and performance management needs of government programs including Medicaid and Medicare.
  • Develop dashboards and prepare analytics for internal and external stakeholders and - leadership.
  • Analyze performance dashboards and results, identify opportunities and areas for product improvement.
  • Produce benefit level score cards to monitor cost and utilization activity.
  • Produce reports to support and manage miscellaneous outreach activities, i.e. NH, MSP, ESRD, MA Non Payments, and others
  • Ensure the integrity and accuracy of data used for reporting across Government Programs. 
  • Responsible for Medicaid regulatory report production and validate accuracy with the Medicaid team and other business owners.
  • Serve as EH Government Programs reporting and analytics subject matter expert. 
  • Mentor and develop staff to support production of needed reports and analysis, facilitate understanding of Government Program financial goals and objectives across the organization.
     

Qualifications:
Bachelor’s Degree required; MBA or equivalent preferred
5-8 years of relevant work experience, including positions of increasing scope and responsibility (R)
3-5 years of government programs healthcare experience (R)
Experience in using metrics and analytics to quantify goals and results, and in presenting information in usable form (R)
Excellent communication skills (verbal, written, presentation), including the ability to negotiate and persuade, with all levels and types of audiences, both internally and externally (R)
Industry level knowledge of Medicaid and Medicare rules, regulations, and processes (P)
Demonstrated ability to effectively execute on multiple competing priority items/tasks/projects (R)
Working knowledge of program management (P)
Proficiency in MS Office suite (excel, word, access, power point) and analytics/ programming (SAS, SQL) (R)

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