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Utilization Management Senior Analyst

Date:  Jun 15, 2022
Brand:  EyeMed Vision Care
Location: 

Mason, OH, US, 45040

Requisition ID: 630722 
Position:Full-Time
Total Rewards: Benefits/Incentive Information

 

There’s more to EyeMed than meets the eye. EyeMed is the fastest growing managed vision benefits company in the country with consistent double-digit membership growth! Through our commitment to innovation, we’re reimagining the way employers and their employees think about vision care. We want them to see life to the fullest and experience more of what’s best, not more of the same.  And if what’s best hasn’t been done yet, it’s our exceptional and passionate employees driving this change. But, our passion for vision isn’t just about vision insurance benefits. Our employees are proud to support and participate in life-altering global and local missions through our partnership with OneSight, a leading not-for-profit organization with a 100% focus on eradicating the world’s vision crisis.

 

Your family says a lot about who you are. EyeMed is a key member of the Luxottica family of companies, global leaders in the design, manufacture and distribution of fashion, luxury and sports eyewear.  In North America, Luxottica is the home to global brands Ray-Ban, Oakley and many top fashion house brands.  Our leading retail brands include LensCrafters, Sunglass Hut, Pearle Vision, and Target Optical.

 

If you’re passionate about driving innovation and change and interested in a career in the optical and insurance industry, EyeMed wants to start the conversation and help provide you a growth-focused opportunity with America’s fastest growing vision benefits company.

GENERAL FUNCTION

The Sr. Analyst will play a critical role within the Provider Data team to develop and deliver incisive, value generating insight and analysis for the EyeMed organization. The Sr. Analyst will work with key functional area partners to understand the true business needs, conduct comprehensive data analysis, derive actionable insights, and create analytical solutions.

 

MAJOR DUTIES AND RESPONSIBILITIES

  • Provide Business Analytic support and analytical solution development to EyeMed Provider Relations and Utilization Management:
  • Consults with nurse reviewer, clinical peer reviewer or the Medical Director as needed to support clinical requirements for Utilization Management.
  • Conduct and execute standard provider network analysis, GEO Coding and Disruptive Analysis using Excel, Quest Analytics, and Access
  • Provide business/data analysis and reporting expertise for Provider Relations and Utilization Management processes and system solutions: Develop and maintain tracking reports and dashboards in excel or other tools.
  • Work closely with business stakeholders to understand, define, develop, and execute insight and analytical solutions to drive tangible business results for EyeMed Utilization Management.
  • Collaborate and partner with others from across the organization to use data driven insights and solutions to execute business strategies.
  • Learn and monitor industry trends and best practices to continuously improve UM initiatives.
  • Working with the business stakeholders to understand, define and support data requirements for UM requests.     

 

BASIC QUALIFICATIONS

  • Bachelor’s Degree in quantitative fields is required.
  • 3+ years of experience in analyzing data to derive actionable insights and applying data science to solve business problems.
  • Excellent communication, analytics, problem-solving, planning, project management, teamwork and organization skills.
  • Proficient in Excel/Access/SQL.
  • Proficient in manipulating large and complex data sets.
  • Strong capability of extrapolating meaningful hypotheses from business problems
  • Able to independently design analysis and gain actionable insights from data.
  • Strong capability of multi-tasking and managing tight project timelines.
  • Experience of extracting data from different systems, such as, Oracle, Access, AS400, etc.
  • Strong balance of business, data science techniques, and technology acumen.

 

PREFERRED QUALIFICATIONS

  • 3+ years of experience in health care administration and/or utilization management with knowledge of Medicaid/Medicare concepts
  • Knowledge and experience of designing and executing experiment design for strategic testing.
  • QlikView or similar visualization software experience preferred.

Upon request and consistent with applicable laws, Luxottica will provide reasonable accommodations to individuals with disabilities who need assistance in the application and hiring process.  To request a reasonable accommodation, please call the Luxottica Ethics Compliance Hotline at 1-888-887-3348 (be sure to provide your name and contact information so that we may follow up in a timely manner). 

We are an Equal Opportunity Employer.  All qualified applicants will receive consideration for employment without regard to race, color, gender, national origin, social origin, social condition, being perceived as a victim of domestic violence, sexual aggression or stalking, religion, age, disability, sexual orientation, gender identity or expression, citizenship, ancestry, veteran or military status, marital status, pregnancy (including unlawful discrimination on the basis of a legally protected pregnancy or maternity leave), genetic information or any other characteristics protected by law.  Native Americans receive preference in accordance with Tribal Law.


Nearest Major Market: Cincinnati

Job Segment: Healthcare Administration, Medicaid, Medicare, Manager, Healthcare, Management

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